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Algül E, Özbeyaz NB, Şahan HF, Aydınyılmaz F, Sunman H, Tulmaç M. Stress Hyperglycemia Ratio Is Associated With High Thrombus Burden in Patients With Acute Coronary Syndrome. Angiology 2024; 75:645-650. [PMID: 37005730 DOI: 10.1177/00033197231167054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
The blood glucose level at admission indicates (with some limitations) poor prognosis and thrombus burden in patients with the acute coronary syndrome (ACS). Our study aimed to measure the predictive value of the stress hyperglycemia ratio (SHR), an indicator of stress hyperglycemia, showing increased thrombus burden in patients with ACS. Patients (n = 1222) with ACS were enrolled in this cross-sectional study. Coronary thrombus burden was classified as high and low. SHR was calculated by dividing the admission serum glucose by the estimated average glucose derived from HbA1c. Low thrombus burden was detected in 771 patients, while high thrombus burden (HTB) was detected in 451 patients. SHR was found to be significantly higher in patients with HTB (1.1 ± .3 vs 1.06 ± .4; P = .002). SHR was determined as a predictor of HTB (odds ratio (OR) 1.547 95% CI (1.139-2.100), P < .001) as a result of univariate analysis. According to multivariate analysis, SHR was determined as an independent risk factor for HTB (OR 1.328 CI (1.082-1.752), P = .001). We found that SHR predicted thrombus burden with higher sensitivity than admission glucose level in patients with ACS.
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Affiliation(s)
- Engin Algül
- Department of Cardiology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Nail Burak Özbeyaz
- Department of Cardiology Clinic, Pursaklar State Hospital, Ankara, Turkey
| | - Haluk Furkan Şahan
- Department of Cardiology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Faruk Aydınyılmaz
- Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Hamza Sunman
- Department of Cardiology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Murat Tulmaç
- Department of Cardiology, University of Health Sciences, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
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Liu C, Pan X, Hao Z, Wang X, Wang C, Song G. Resveratrol suppresses hepatic fatty acid synthesis and increases fatty acid β-oxidation via the microRNA-33/SIRT6 signaling pathway. Exp Ther Med 2024; 28:326. [PMID: 38979023 PMCID: PMC11229395 DOI: 10.3892/etm.2024.12615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/23/2024] [Indexed: 07/10/2024] Open
Abstract
Hyperlipidemia is a strong risk factor for numerous diseases. Resveratrol (Res) is a non-flavonoid polyphenol organic compound with multiple biological functions. However, the specific molecular mechanism and its role in hepatic lipid metabolism remain unclear. Therefore, the aim of the present study was to elucidate the mechanism underlying how Res improves hepatic lipid metabolism by decreasing microRNA-33 (miR-33) levels. First, blood miR-33 expression in participants with hyperlipidemia was detected by reverse transcription-quantitative PCR, and the results revealed significant upregulation of miR-33 expression in hyperlipidemia. Additionally, after transfection of HepG2 cells with miR-33 mimics or inhibitor, western blot analysis indicated downregulation and upregulation, respectively, of the mRNA and protein expression levels of sirtuin 6 (SIRT6). Luciferase reporter analysis provided further evidence for binding of miR-33 with the SIRT6 3'-untranslated region. Furthermore, the levels of peroxisome proliferator-activated receptor-γ (PPARγ), PPARγ-coactivator 1α and carnitine palmitoyl transferase 1 were increased, while the concentration levels of acetyl-CoA carboxylase, fatty acid synthase and sterol regulatory element-binding protein 1 were decreased when SIRT6 was overexpressed. Notably, Res improved the basic metabolic parameters of mice fed a high-fat diet by regulating the miR-33/SIRT6 signaling pathway. Thus, it was demonstrated that the dysregulation of miR-33 could lead to lipid metabolism disorders, while Res improved lipid metabolism by regulating the expression of miR-33 and its target gene, SIRT6. Thus, Res can be used to prevent or treat hyperlipidemia and associated diseases clinically by suppressing hepatic fatty acid synthesis and increasing fatty acid β-oxidation.
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Affiliation(s)
- Chunqiao Liu
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Xinyan Pan
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Zhihua Hao
- Department of Health Care, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Xing Wang
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Chao Wang
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Guangyao Song
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
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Pan H, Xiong Y, Huang Y, Zhao J, Wan H. Association between stress hyperglycemia ratio with short-term and long-term mortality in critically ill patients with ischemic stroke. Acta Diabetol 2024; 61:859-868. [PMID: 38499778 DOI: 10.1007/s00592-024-02259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/11/2024] [Indexed: 03/20/2024]
Abstract
AIMS Hyperglycemia on admission is associated with poor prognosis in ischemic stroke (IS) patients. We aimed to investigate the relationship between stress hyperglycemia ratio (SHR) and short-term or long-term mortality in IS patients in the ICU and to explore whether this relationship is influenced by diabetes status. MATERIALS AND METHODS We collected patients with severe IS requiring ICU admission in the Medical Information Mart for Intensive Care (MIMIC-IV) database and calculated SHR. Outcomes included 30-day, 90-day, and 1-year mortality. The association between SHR and mortality in patients with critical IS was elucidated using Multivariate Cox regression and subgroup analysis for diabetes. RESULTS A total of 1376 patients were recruited. After adjusting for potential confounders, patients in the third and fourth quartiles had a significantly increased risk of death at 30 days, 90 days, and 1 year compared to the first quartile of SHR (Q3 vs. Q1: HR 1.56-1.80, all p < 0.02; Q4 vs. Q1: HR 1.75-2.15, all p < 0.001; all p for trend < 0.001). In addition, the highest quartile of SHR was significantly associated with short-term or long-term mortality compared with the first quartile, regardless of diabetes status. CONCLUSIONS Our results suggest that stress hyperglycemia, defined by the glucose/HbA1c ratio, is associated with increased short-term and long-term mortality in patients with ischemic stroke, independent of the patient's diabetes status.
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Affiliation(s)
- Haowei Pan
- Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yiqun Xiong
- Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yanming Huang
- Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Anesthesiology, Hangzhou Red Cross Hospital, 208 East Huancheng Road, Hangzhou, 310003, China
| | - Jie Zhao
- Department of Anesthesiology, Hangzhou Red Cross Hospital, 208 East Huancheng Road, Hangzhou, 310003, China
| | - Haifang Wan
- Department of Anesthesiology, Hangzhou Red Cross Hospital, 208 East Huancheng Road, Hangzhou, 310003, China.
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WANG WJ, WANG KX, NIU JL, LIU YX, GE HL, SHEN H. Association between stress hyperglycemia ratio and in-hospital outcomes: findings from the improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) Project. J Geriatr Cardiol 2024; 21:658-668. [PMID: 38973822 PMCID: PMC11224654 DOI: 10.26599/1671-5411.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND Stress hyperglycemia ratio (SHR) could provide accurate information on the acute status of hyperglycemia. The relationship between SHR and acute coronary syndrome (ACS) prognosis remains unclear. This study was conducted to identity the association between SHR and in-hospital outcomes in patients with ACS. METHODS A total of 12,010 patients were eventually enrolled in the study. The relationship between SHR and in-hospital major adverse cardiovascular events (MACEs) was then modeled by restricted cubic spline (RCS) curves, and all patients were divided into three groups according to the results. The multivariate logistic regression analysis was used to determine the associations between the SHR and in-hospital outcomes, described as odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were also performed on different diseases. RESULTS The median age of this cohort was 63 (54, 71) years old, and 8942 (74.5%) were male. Group 1 was defined as SHR < 0.6 (n = 426), Group 2 was defined as SHR between 0.6 and 1 (n = 5821), and Group 3 was defined as SHR > 1 (n = 5763). Compared with Group 2, Group 1 (OR = 1.891, 95% CI: 1.028-3.479, P < 0.001) and Group 3 (OR = 1.868, 95% CI: 1.434-2.434, P < 0.001) had higher risks of suffering from in-hospital MACEs. SHR was associated with higher risks of in-hospital MACEs in the subgroups of DM [OR = 2.282, 95% CI: 1.477-3.524). CONCLUSIONS Both low and high SHR levels were independently associated with in-hospital MACEs. Young males with DM, hypertension, and decreased renal function had much higher risks of suffering from SHR-correlated MACEs.
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Affiliation(s)
- Wen-Jie WANG
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ke-Xin WANG
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jia-Long NIU
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yi-Xuan LIU
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hai-Long GE
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hua SHEN
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Hu B, Chen X, Wang Y, Wei X, Feng J, Hou L. J-shaped relationship between stress hyperglycemia ratio and 90-day and 180-day mortality in patients with a first diagnosis of acute myocardial infarction: analysis of the MIMIC-IV database. Diabetol Metab Syndr 2024; 16:132. [PMID: 38880917 PMCID: PMC11181615 DOI: 10.1186/s13098-024-01380-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 06/11/2024] [Indexed: 06/18/2024] Open
Abstract
AIMS The Stress Hyperglycemia Ratio (SHR) potently predicts adverse outcomes in patients with cardiovascular and cerebrovascular diseases. However, the relationship between SHR and short-term mortality risk in patients with a first diagnosis of acute myocardial infarction (AMI) remains contentious. This study sought to understand better the relationship between SHR and short-term mortality risk in patients with a first diagnosis of AMI. METHODS We conducted a cohort study using data from 1961 patients with a first diagnosis of AMI from the MIMIC-IV (version 2.2) database. Patients were divided into three groups based on SHR tertiles. The Cox proportional hazards model and a two-segmented Cox proportional hazards model were used to elucidate the nonlinear relationship between SHR in patients with a first diagnosis of AMI and mortality. RESULTS Of the surveyed population, 175 patients (8.92%) died within 90 days, and 210 patients (10.71%) died within 180 days. After multivariate adjustments, elevated SHR levels were significantly and non-linearly associated with a higher risk of 90-day and 180-day mortality in patients with a first diagnosis of AMI, showing a J-shaped correlation with an inflection point at 0.9. Compared to participants with SHR levels below the inflection point, those with higher SHR levels had a fivefold increased risk of 90-day mortality (hazard ratio [HR] 5.74; 95% confidence interval [CI] 3.19, 10.33) and a fourfold increased risk of 180-day mortality (HR 4.56; 95% CI 2.62, 7.95). In the subgroup analysis, patients with pre-diabetes mellitus (pre-DM) and higher SHR levels had increased 90-day (HR 6.90; 95% CI 1.98, 24.02) and 180-day mortality risks (HR 5.30; 95% CI 1.96, 14.27). CONCLUSION In patients with a first diagnosis of AMI, there is a J-shaped correlation between SHR and 90-day and 180-day mortality, with an adverse prognostic inflection point of SHR at 0.9.
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Affiliation(s)
- Ben Hu
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, 230000, Anhui, China
| | - Xinghua Chen
- Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Yuhui Wang
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Xing Wei
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Jun Feng
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China.
| | - Linlin Hou
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China.
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, 230000, Anhui, China.
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Lian LY, Xue WH, Lu JJ, Zheng RJ. Impact of stress hyperglycemia ratio on mortality in patients with cardiac arrest: insight from American MIMIC-IV database. Front Endocrinol (Lausanne) 2024; 15:1383993. [PMID: 38836227 PMCID: PMC11148256 DOI: 10.3389/fendo.2024.1383993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Background Stress hyperglycemia ratio (SHR) has shown a predominant correlation with transient adverse events in critically ill patients. However, there remains a gap in comprehensive research regarding the association between SHR and mortality among patients experiencing cardiac arrest and admitted to the intensive care unit (ICU). Methods A total of 535 patients with their initial ICU admission suffered cardiac arrest, according to the American Medical Information Mart for Intensive Care (MIMIC)-IV database. Patients were stratified into four categories based on quantiles of SHR. Multivariable Cox regression models were used to evaluate the association SHR and mortality. The association between SHR and mortality was assessed using multivariable Cox regression models. Subgroup analyses were conducted to determine whether SHR influenced ICU, 1-year, and long-term all-cause mortality in subgroups stratified according to diabetes status. Results Patients with higher SHR, when compared to the reference quartile 1 group, exhibited a greater risk of ICU mortality (adjusted hazard ratio [aHR] = 3.029; 95% CI: 1.802-5.090), 1-year mortality (aHR = 3.057; 95% CI: 1.885-4.958), and long-term mortality (aHR = 3.183; 95% CI: 2.020-5.015). This association was particularly noteworthy among patients without diabetes, as indicated by subgroup analysis. Conclusion Elevated SHR was notably associated with heightened risks of ICU, 1-year, and long-term all-cause mortality among cardiac arrest patients. These findings underscore the importance of considering SHR as a potential prognostic factor in the critical care management of cardiac arrest patients, warranting further investigation and clinical attention.
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Affiliation(s)
- Li-You Lian
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wei-Hao Xue
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jia-Jia Lu
- Department of Public Education, Zhangzhou Institute of Technology, Zhangzhou, China
| | - Ru-Jie Zheng
- Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Taktaz F, Scisciola L, Fontanella RA, Pesapane A, Ghosh P, Franzese M, Tortorella G, Puocci A, Sommella E, Signoriello G, Olivieri F, Barbieri M, Paolisso G. Evidence that tirzepatide protects against diabetes-related cardiac damages. Cardiovasc Diabetol 2024; 23:112. [PMID: 38555463 PMCID: PMC10981817 DOI: 10.1186/s12933-024-02203-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are effective antidiabetic drugs with potential cardiovascular benefits. Despite their well-established role in reducing the risk of major adverse cardiovascular events (MACE), their impact on heart failure (HF) remains unclear. Therefore, our study examined the cardioprotective effects of tirzepatide (TZT), a novel glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) receptor agonist. METHODS A three-steps approach was designed: (i) Meta-analysis investigation with the primary objective of assessing major adverse cardiovascular events (MACE) occurrence from major randomized clinical trials.; (ii) TZT effects on a human cardiac AC16 cell line exposed to normal (5 mM) and high (33 mM) glucose concentrations for 7 days. The gene expression and protein levels of primary markers related to cardiac fibrosis, hypertrophy, and calcium modulation were evaluated. (iii) In silico data from bioinformatic analyses for generating an interaction map that delineates the potential mechanism of action of TZT. RESULTS Meta-analysis showed a reduced risk for MACE events by TZT therapy (HR was 0.59 (95% CI 0.40-0.79, Heterogeneity: r2 = 0.01, I2 = 23.45%, H2 = 1.31). In the human AC16 cardiac cell line treatment with 100 nM TZT contrasted high glucose (HG) levels increase in the expression of markers associated with fibrosis, hypertrophy, and cell death (p < 0.05 for all investigated markers). Bioinformatics analysis confirmed the interaction between the analyzed markers and the associated pathways found in AC16 cells by which TZT affects apoptosis, fibrosis, and contractility, thus reducing the risk of heart failure. CONCLUSION Our findings indicate that TZT has beneficial effects on cardiac cells by positively modulating cardiomyocyte death, fibrosis, and hypertrophy in the presence of high glucose concentrations. This suggests that TZT may reduce the risk of diabetes-related cardiac damage, highlighting its potential as a therapeutic option for heart failure management clinical trials. Our study strongly supports the rationale behind the clinical trials currently underway, the results of which will be further investigated to gain insights into the cardiovascular safety and efficacy of TZT.
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Affiliation(s)
- Fatemeh Taktaz
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
| | - Lucia Scisciola
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy.
| | - Rosaria Anna Fontanella
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
| | - Ada Pesapane
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
| | - Puja Ghosh
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
| | - Martina Franzese
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
| | - Giovanni Tortorella
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
| | - Armando Puocci
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
| | - Eduardo Sommella
- Department of Pharmacy, University of Salerno, Fisciano, SA, Italy
| | - Giuseppe Signoriello
- Department of Mental Health and Public Medicine, Section of Statistic, University of Campania, Naples, Italy
| | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy
- Center of Clinical Pathology and Innovative Therapy, IRCCS INRCA, Ancona, Italy
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania ''Luigi Vanvitelli'', P.zza L. Miraglia, 2, 80138, Naples, Italy
- UniCamillus, International Medical University, Rome, Italy
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Bettiol A, Urban ML, Emmi G, Galora S, Argento FR, Fini E, Borghi S, Bagni G, Mattioli I, Prisco D, Fiorillo C, Becatti M. SIRT1 and thrombosis. Front Mol Biosci 2024; 10:1325002. [PMID: 38304233 PMCID: PMC10833004 DOI: 10.3389/fmolb.2023.1325002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/29/2023] [Indexed: 02/03/2024] Open
Abstract
Thrombosis is a major cause of morbidity and mortality worldwide, with a complex and multifactorial pathogenesis. Recent studies have shown that SIRT1, a member of the sirtuin family of NAD + -dependent deacetylases, plays a crucial role in regulating thrombosis, modulating key pathways including endothelial activation, platelet aggregation, and coagulation. Furthermore, SIRT1 displays anti-inflammatory activity both in vitro, in vivo and in clinical studies, particularly via the reduction of oxidative stress. On these bases, several studies have investigated the therapeutic potential of targeting SIRT1 for the prevention of thrombosis. This review provides a comprehensive and critical overview of the main preclinical and clinical studies and of the current understanding of the role of SIRT1 in thrombosis.
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Affiliation(s)
- Alessandra Bettiol
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Maria Letizia Urban
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Silvia Galora
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, Firenze, Italy
| | - Flavia Rita Argento
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, Firenze, Italy
| | - Eleonora Fini
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, Firenze, Italy
| | - Serena Borghi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, Firenze, Italy
| | - Giacomo Bagni
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Irene Mattioli
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Domenico Prisco
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Claudia Fiorillo
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, Firenze, Italy
| | - Matteo Becatti
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, Firenze, Italy
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Liu J, Hu X. Association between glucose-to-lymphocyte ratio and in-hospital mortality in acute myocardial infarction patients. PLoS One 2023; 18:e0295602. [PMID: 38060551 PMCID: PMC10703328 DOI: 10.1371/journal.pone.0295602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Inflammation is involved in the development and progression of atherosclerosis. Recent studies indicated that glucose-to-lymphocyte ratio (GLR) level were significantly associated with the risk of mortality from inflammatory diseases, and showed a specific prognostic value. Herein, this study intended to explore the association between GLR level and in-hospital mortality in patients with acute myocardial infarction (AMI), and evaluate the predictive value of GLR on AMI prognosis. METHODS Data of patients with AMI were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database in 2012-2019 in this retrospective cohort study. Univariate COX proportional hazard model was used to screen covariates. The associations between GLR and in-hospital mortality were evaluated using univariate and multivariate COX proportional hazard models. Subgroup analysis of age, gender, vasopressor use, SOFA scores, renal replacement therapy, coronary artery bypass graft, and β blockers use were performed. The evaluated index was hazard ratios (HRs) and 95% confidence intervals (CIs). In addition, the predictive performance of GLR, glucose, and lymphocytes on in-hospital mortality was assessed respectively. RESULTS Among eligible patients, 248 (13.74%) died in the hospital. After adjusting for covariates, we found that a higher GLR level was associated with an increased risk of in-hospital mortality [HR = 1.70, 95%CI: (1.24-2.34)]. This relationship was also found in patients who were male, aged ≥65 years old, did not have renal replacement therapy, coronary artery bypass graft, or β blockers, used vasopressor or not, and whatever the SOFA scores (all P<0.05). Moreover, the predictive performance of GLR on in-hospital mortality seemed superior to that of glucose or lymphocytes. CONCLUSION GLR may be a potential predictor for AMI prognosis, which provided some references for identifying and managing high-risk populations early in clinical.
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Affiliation(s)
- Jing Liu
- Department of Emergency (West Branch), The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, P.R. China
| | - Xiaogang Hu
- Department of Internal Medicine, Shanxi Agricultural University Hospital, Taiyuan, Shanxi, P.R. China
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Liu J, Zhou Y, Huang H, Liu R, Kang Y, Zhu T, Wu J, Gao Y, Li Y, Wang C, Chen S, Xie N, Zheng X, Meng R, Liu Y, Tan N, Gao F. Impact of stress hyperglycemia ratio on mortality in patients with critical acute myocardial infarction: insight from american MIMIC-IV and the chinese CIN-II study. Cardiovasc Diabetol 2023; 22:281. [PMID: 37865764 PMCID: PMC10589959 DOI: 10.1186/s12933-023-02012-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/04/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Among patients with acute coronary syndrome and percutaneous coronary intervention, stress hyperglycemia ratio (SHR) is primarily associated with short-term unfavorable outcomes. However, the relationship between SHR and long-term worsen prognosis in acute myocardial infarction (AMI) patients admitted in intensive care unit (ICU) are not fully investigated, especially in those with different ethnicity. This study aimed to clarify the association of SHR with all-cause mortality in critical AMI patients from American and Chinese cohorts. METHODS Overall 4,337 AMI patients with their first ICU admission from the American Medical Information Mart for Intensive Care (MIMIC)-IV database (n = 2,166) and Chinese multicenter registry cohort Cardiorenal ImprovemeNt II (CIN-II, n = 2,171) were included in this study. The patients were divided into 4 groups based on quantiles of SHR in both two cohorts. RESULTS The total mortality was 23.8% (maximum follow-up time: 12.1 years) in American MIMIC-IV and 29.1% (maximum follow-up time: 14.1 years) in Chinese CIN-II. In MIMIC-IV cohort, patients with SHR of quartile 4 had higher risk of 1-year (adjusted hazard radio [aHR] = 1.87; 95% CI: 1.40-2.50) and long-term (aHR = 1.63; 95% CI: 1.27-2.09) all-cause mortality than quartile 2 (as reference). Similar results were observed in CIN-II cohort (1-year mortality: aHR = 1.44; 95%CI: 1.03-2.02; long-term mortality: aHR = 1.32; 95%CI: 1.05-1.66). In both two group, restricted cubic splines indicated a J-shaped correlation between SHR and all-cause mortality. In subgroup analysis, SHR was significantly associated with higher 1-year and long-term all-cause mortality among patients without diabetes in both MIMIC-IV and CIN-II cohort. CONCLUSION Among critical AMI patients, elevated SHR is significantly associated with and 1-year and long-term all-cause mortality, especially in those without diabetes, and the results are consistently in both American and Chinese cohorts.
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Affiliation(s)
- Jin Liu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yang Zhou
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haozhang Huang
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Rui Liu
- School of Mathematics, South China University of Technology, Guangzhou, China
| | - Yu Kang
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Tingting Zhu
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Jielan Wu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yuwei Gao
- Jinan university, Zhuhai People's Hospital, Zhuhai, China
| | - Yuqi Li
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Cardiology, Zhongshan City People's Hospital, Zhongshan, China
| | - Chenyang Wang
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shiqun Chen
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Nianjin Xie
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xueyan Zheng
- Institute of Control and Prevention for Chronic Non-infective Disease, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Ruilin Meng
- Institute of Control and Prevention for Chronic Non-infective Disease, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Yong Liu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
| | - Ning Tan
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Southern Medical University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
| | - Fei Gao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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11
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Belli M, Bellia A, Sergi D, Barone L, Lauro D, Barillà F. Glucose variability: a new risk factor for cardiovascular disease. Acta Diabetol 2023; 60:1291-1299. [PMID: 37341768 PMCID: PMC10442283 DOI: 10.1007/s00592-023-02097-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/11/2023] [Indexed: 06/22/2023]
Abstract
AIMS AND DATA SYNTHESIS Glucose variability (GV) is increasingly considered an additional index of glycemic control. Growing evidence indicates that GV is associated with diabetic vascular complications, thus being a relevant point to address in diabetes management. GV can be measured using various parameters, but to date, a gold standard has not been identified. This underscores the need for further studies in this field also to identify the optimal treatment. CONCLUSIONS We reviewed the definition of GV, the pathogenetic mechanisms of atherosclerosis, and its relationship with diabetic complications.
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Affiliation(s)
- Martina Belli
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133, Rome, Italy
- Cardiovascular Imaging Unit, San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Alfonso Bellia
- Department of Systems Medicine, Tor Vergata University, 00133, Rome, Italy
| | - Domenico Sergi
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133, Rome, Italy
| | - Lucy Barone
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133, Rome, Italy
| | - Davide Lauro
- Department of Systems Medicine, Tor Vergata University, 00133, Rome, Italy
| | - Francesco Barillà
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133, Rome, Italy.
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12
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Zeng Q, Li W, Luo Z, Zhou H, Duan Z, Xiong XL. The role of miR1 and miR133a in new-onset atrial fibrillation after acute myocardial infarction. BMC Cardiovasc Disord 2023; 23:448. [PMID: 37697243 PMCID: PMC10496401 DOI: 10.1186/s12872-023-03462-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/19/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND The development of new-onset atrial fibrillation (NOAF) after acute myocardial infarction (AMI) is a clinical complication that requires a better understanding of the causative risk factors. This study aimed to explore the risk factors and the expression and function of miR-1 and miR-133a in new atrial fibrillation after AMI. METHODS We collected clinical data from 172 patients with AMI treated with emergency percutaneous coronary intervention (PCI) between October 2021 and October 2022. Independent predictors of NOAF were determined using binary logistic univariate and multivariate regression analyses. The predictive value of NOAF was assessed using the area under the receiver operating characteristic (ROC) curve for related risk factors. In total, 172 venous blood samples were collected preoperatively and on the first day postoperatively; the expression levels of miR-1 and miR-133a were determined using the polymerase chain reaction. The clinical significance of miR-1 and miR-133a expression levels was determined by Spearman correlation analysis. RESULTS The Glasgow prognostic score, left atrial diameter, and infarct area were significant independent risk factors for NOAF after AMI. We observed that the expression levels of miR-1 and miR-133a were significantly higher in the NOAF group than in the non-NOAF group. On postoperative day 1, strong associations were found between miR-133a expression levels and the neutrophil ratio and between miR-1 expression levels and an increased left atrial diameter. CONCLUSIONS Our findings indicate that the mechanism of NOAF after AMI may include an inflammatory response associated with an increased miR-1-related mechanism. Conversely, miR-133a could play a protective role in this clinical condition.
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Affiliation(s)
- Qingyi Zeng
- Guizhou Medical University, 9 Beijing Road, Guiyang, 550000, Guizhou, China
- The Second Affiliated Hospital of Guizhou University of Chinese Medicine, 83 Feishan Street, Guiyang, China
| | - Wei Li
- Guizhou Medical University, 9 Beijing Road, Guiyang, 550000, Guizhou, China.
- Affiliated Hospital of Guizhou Medical University, 16 Beijing Road, Guiyang, 550000, Guizhou, China.
| | - Zhenghua Luo
- Guizhou Provincial People's Hospital, 83 Zhongshan East Road, Guiyang, 55000, Guizhou, China
| | - Haiyan Zhou
- Guizhou Medical University, 9 Beijing Road, Guiyang, 550000, Guizhou, China
- Affiliated Hospital of Guizhou Medical University, 16 Beijing Road, Guiyang, 550000, Guizhou, China
| | - Zhonggang Duan
- Guizhou Medical University, 9 Beijing Road, Guiyang, 550000, Guizhou, China
- Affiliated Hospital of Guizhou Medical University, 16 Beijing Road, Guiyang, 550000, Guizhou, China
| | - Xin Lin Xiong
- Guizhou Medical University, 9 Beijing Road, Guiyang, 550000, Guizhou, China
- Affiliated Hospital of Guizhou Medical University, 16 Beijing Road, Guiyang, 550000, Guizhou, China
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13
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Amezcua-Guerra B, Amezcua-Castillo LM, Guerra-López JA, Díaz-Domínguez KA, Sánchez-Gloria JL, Cruz-Melendez A, Hernández-Díazcouder A, Juárez-Vicuña Y, Sánchez-Muñoz F, Huang F, Tavera-Alonso C, Brianza-Padilla M, Varela-López E, Sierra-Lara D, Arias-Mendoza A, Fonseca-Camarillo G, Márquez-Velasco R, González-Pacheco H, Springall R, Amezcua-Guerra LM. Diagnostic Performance of Serum MicroRNAs for ST-Segment Elevation Myocardial Infarction in the Emergency Department. Biomedicines 2023; 11:2422. [PMID: 37760864 PMCID: PMC10525983 DOI: 10.3390/biomedicines11092422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Prompt diagnosis of ST-segment elevation myocardial infarction (STEMI) is essential for initiating timely treatment. MicroRNAs have recently emerged as biomarkers in cardiovascular diseases. This study aimed to evaluate the discriminatory capacity of serum microRNAs in identifying an ischemic origin in patients presenting with chest discomfort to the Emergency Department. The study included 98 participants (78 with STEMI and 20 with nonischemic chest discomfort). Significant differences in the expression levels of miR-133b, miR-126, and miR-155 (but not miR-1, miR-208, and miR-208b) were observed between groups. miR-133b and miR-155 exhibited 97% and 93% sensitivity in identifying STEMI patients, respectively. miR-126 demonstrated a specificity of 90% in identifying STEMI patients. No significant associations were found between microRNAs and occurrence of major adverse cardiovascular events (MACE). However, patients with MACE had higher levels of interleukin (IL)-15, IL-21, IFN-γ-induced protein-10, and N-terminal pro B-type natriuretic peptide compared to non-MACE patients. Overall, there were significant associations among the expression levels of microRNAs. However, microRNAs did not demonstrate associations with either inflammatory markers or cardiovascular risk scores. This study highlights the potential of microRNAs, particularly miR-133b and miR-126, as diagnostic biomarkers for distinguishing patients with STEMI from those presenting with nonischemic chest discomfort to the Emergency Department.
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Affiliation(s)
| | - Luis M. Amezcua-Castillo
- Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (L.M.A.-C.); (D.S.-L.); (A.A.-M.); (H.G.-P.)
| | - Jazmín A. Guerra-López
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
| | - Kietseé A. Díaz-Domínguez
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
| | - José L. Sánchez-Gloria
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA
| | - Andrés Cruz-Melendez
- Core Lab, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (A.C.-M.); (C.T.-A.)
| | - Adrián Hernández-Díazcouder
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
- Research Laboratory of Obesity and Asthma, Hospital Infantil de Mexico Federico Gómez, Mexico City 06720, Mexico;
| | - Yaneli Juárez-Vicuña
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
| | - Fausto Sánchez-Muñoz
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
| | - Fengyang Huang
- Research Laboratory of Obesity and Asthma, Hospital Infantil de Mexico Federico Gómez, Mexico City 06720, Mexico;
| | - Claudia Tavera-Alonso
- Core Lab, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (A.C.-M.); (C.T.-A.)
| | - Malinalli Brianza-Padilla
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
| | - Elvira Varela-López
- Translational Research Unit UNAM–INC, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico;
| | - Daniel Sierra-Lara
- Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (L.M.A.-C.); (D.S.-L.); (A.A.-M.); (H.G.-P.)
| | - Alexandra Arias-Mendoza
- Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (L.M.A.-C.); (D.S.-L.); (A.A.-M.); (H.G.-P.)
| | - Gabriela Fonseca-Camarillo
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
| | - Ricardo Márquez-Velasco
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
| | - Héctor González-Pacheco
- Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (L.M.A.-C.); (D.S.-L.); (A.A.-M.); (H.G.-P.)
| | - Rashidi Springall
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
| | - Luis M. Amezcua-Guerra
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (J.A.G.-L.); (K.A.D.-D.); (J.L.S.-G.); (A.H.-D.); (Y.J.-V.); (F.S.-M.); (M.B.-P.); (G.F.-C.); (R.M.-V.)
- Health Care Department, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 14387, Mexico
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14
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Xu X, Shi Y, Yu Q, Peng Y, Zhao F, Cui J, Chen Y, Liu L, Zhang Y, Zhang J, Wei B. Coumarin-derived imino sulfonate 5h ameliorates cardiac injury induced by myocardial infarction via activating the Sirt1/Nrf2 signaling pathway. Eur J Pharmacol 2023; 945:175615. [PMID: 36841283 DOI: 10.1016/j.ejphar.2023.175615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
Myocardial infarction (MI) is irreversible damage caused by ischemia and hypoxia in coronary arteries accompanied by elevated catecholamine levels, leading to the accumulation of free radicals. Our previous study discovered coumarin-derived imino sulfonates as a novel class of potential cardioprotective agents possessing strong anti-oxidative effects in cardiomyocytes. Therefore, identifying the compound with the highest cardioprotective activity, 5h, and the mechanism involved was necessary. As a kind of catecholamine, isoproterenol can clinically induce myocardial infarction injury similar to the symptoms of myocardial infarction patients. Our experiments explored the underlying mechanism of this effect of compound 5h by assessing cardiac function, infarct size, histopathological changes, and downregulation of Sirt1 by transfection of adenovirus in vitro and by administering Ex527, a specific inhibitor of Sirt1, in vivo. Compound 5h exhibited strong cardioprotective actions in vivo and in vitro via improving cell survival and cardiac function and decreasing the cellular oxidative stress and cardiac infarct size against MI. Furthermore, compound 5h significantly enhanced cardiac expression of Sirt1, subsequently activating the Nrf2/NQO1 signaling pathway. However, adenovirus-induced Sirt1 downregulation or Sirt1-specific inhibitor largely blocked such beneficial effects of 5h in vitro and in vivo, respectively. Taken together, our results demonstrated, for the first time, that the cardioprotective action of 5h against MI was mediated by reducing oxidative stress and apoptosis through the Sirt1/Nrf2 signaling pathway. Our findings proposed novel insights in developing and evaluating coumarin-derived imino sulfonate compounds as epigenetics-targeted drug therapy for MI.
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Affiliation(s)
- Xueli Xu
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yangyang Shi
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Qingwen Yu
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yajie Peng
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Fei Zhao
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Jing Cui
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yajing Chen
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Lingxu Liu
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yiran Zhang
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China
| | - Ji Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, PR China; Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, 450052, PR China
| | - Bo Wei
- Key Laboratory of Advanced Drug Preparation Technologies, Ministry of Education, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan, 450001, PR China.
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15
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D'Onofrio N, Prattichizzo F, Martino E, Anastasio C, Mele L, La Grotta R, Sardu C, Ceriello A, Marfella R, Paolisso G, Balestrieri ML. MiR-27b attenuates mitochondrial oxidative stress and inflammation in endothelial cells. Redox Biol 2023; 62:102681. [PMID: 37003179 PMCID: PMC10090437 DOI: 10.1016/j.redox.2023.102681] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/16/2023] [Indexed: 03/18/2023] Open
Abstract
MiR-27b is highly expressed in endothelial cells (EC) but its function in this context is poorly characterized. This study aims to investigate the effect of miR-27b on inflammatory pathways, cell cycle, apoptosis, and mitochondrial oxidative imbalances in immortalized human aortic endothelial cells (teloHAEC), human umbilical vein endothelial cells (HUVEC), and human coronary artery endothelial cells (HCAEC) exposed to TNF-α. Treatment with TNF-α downregulates the expression of miR-27b in all EC lines, promotes the activation of inflammatory pathways, induces mitochondrial alteration and reactive oxygen species accumulation, fostering the induction of intrinsic apoptosis. Moreover, miR-27b mimic counteracts the TNF-α-related cytotoxicity and inflammation, as well as cell cycle arrest and caspase-3-dependent apoptosis, restoring mitochondria redox state, function, and membrane polarization. Mechanistically, hsa-miR-27b-3p targets the 3'untranslated regions of FOXO1 mRNA to downregulate its expression, blunting the activation of the Akt/FOXO1 pathway. Here, we show that miR-27b is involved in the regulation of a broad range of functionally intertwined phenomena in EC, suggesting its key role in mitigating mithochondrial oxidative stress and inflammation, most likely through targeting of FOXO1. Overall, results reveal for the first time that miR-27b could represent a possible target for future therapies aimed at improving endothelial health.
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Affiliation(s)
- Nunzia D'Onofrio
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, 80138, Naples, Italy.
| | | | - Elisa Martino
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, 80138, Naples, Italy.
| | - Camilla Anastasio
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, 80138, Naples, Italy.
| | - Luigi Mele
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Via Luciano Armanni 5, 80138, Naples, Italy.
| | | | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Miraglia, 80138, Naples, Italy.
| | | | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Miraglia, 80138, Naples, Italy; Mediterranea Cardiocentro, 80122, Naples, Italy.
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Piazza Miraglia, 80138, Naples, Italy; Mediterranea Cardiocentro, 80122, Naples, Italy.
| | - Maria Luisa Balestrieri
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, 80138, Naples, Italy.
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16
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Li X, Hou X, Zhang H, Qian X, Feng X, Shi N, Guo R, Sun H, Feng W, Zhao W, Li G, Zheng Z, Chen Y. Association between stress hyperglycaemia and in-hospital cardiac events after coronary artery bypass grafting in patients without diabetes: A retrospective observational study of 5450 patients. Diabetes Obes Metab 2023; 25 Suppl 1:34-42. [PMID: 36775931 DOI: 10.1111/dom.15013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/04/2023] [Accepted: 02/08/2023] [Indexed: 02/14/2023]
Abstract
AIMS To investigate the impact of stress hyperglycaemia (SH) on in-hospital adverse cardiac events after coronary artery bypass grafting (CABG) in patients without diabetes. MATERIALS AND METHODS In total, 5450 patients without diabetes who underwent CABG were analysed. SH was defined as any two instances in which the random blood glucose level was >7.8 mmol/L after CABG in the intensive care unit (ICU). The primary outcome was major adverse cardiac events (MACEs), including in-hospital mortality, acute myocardial infarction, stroke and acute renal failure. Secondary outcomes included surgical site infection (SSI) and length of ICU stay. RESULTS Patients with SH had higher rates of MACEs (5.7% vs. 2.3%, p < .0001) and higher SSI (3.3% vs. 1.4%, p = .0003) and longer ICU stays (2.6 ± 2.0 vs. 1.3 ± 1.3 days, p < .0001) than those without SH. Furthermore, SH was associated with a higher risk of MACEs [odds ratio (OR): 2.32, 95% confidence interval (CI): 1.38-3.90], SSI (OR: 2.21, 95% CI: 1.20-3.95) and longer ICU stay (OR: 12.27, 95% CI: 9.41-16.92) after adjusting for confounders. Subgroup analysis showed that patients with SH >10 mmol/L or SH that occurred in the ICU and lasted more than 48 h had increased risks of postoperative complications (p < .05). CONCLUSIONS SH was significantly associated with an increased risk of MACEs, SSI and longer ICU stay after CABG in patients without diabetes. In addition, SH >10 mmol/L or that occurred in the ICU and lasted more than 48 h increased the risk of adverse outcomes.
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Affiliation(s)
- Xiaojue Li
- Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaopei Hou
- Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Heng Zhang
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Qian
- Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinxing Feng
- Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Na Shi
- Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rong Guo
- Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hansong Sun
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Feng
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Zhao
- Information Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Guangwei Li
- Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhe Zheng
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanyan Chen
- Endocrinology Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Endocrinology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
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Zhang C, Shen HC, Liang WR, Ning M, Wang ZX, Chen Y, Su W, Guo TT, Hu K, Liu YW. Relationship between stress hyperglycemia ratio and allcause mortality in critically ill patients: Results from the MIMIC-IV database. Front Endocrinol (Lausanne) 2023; 14:1111026. [PMID: 37077351 PMCID: PMC10106677 DOI: 10.3389/fendo.2023.1111026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/08/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Stress hyperglycemia ratio (SHR) was developed to reduce the impact of long-term chronic glycemic factors on stress hyperglycemia levels, which have been linked to clinical adverse events. However, the relationship between SHR and the short- and long-term prognoses of intensive care unit (ICU) patients remains unclear. METHODS We retrospectively analyzed 3,887 ICU patients (cohort 1) whose initial fasting blood glucose and hemoglobin A1c data within 24 hours of admission were available and 3,636 ICU patients (cohort 2) who were followed-up for 1-year using the Medical Information Mart for Intensive Care IV v2.0 database. Patients were divided into two groups based on the optimal cutoff value of SHR, which was determined using the receiver operating characteristic (ROC) curve. RESULTS There were 176 ICU deaths in cohort 1 and 378 patients experienced all-cause mortality during 1 year of follow-up in cohort 2. The results of logistic regression revealed that SHR was associated with ICU death (odds ratio 2.92 [95% confidence interval 2.14-3.97] P < 0.001), and non-diabetic patients rather than diabetic patients showed an increased risk of ICU death. As per the Cox proportional hazards model, the high SHR group experienced a higher incidence of 1-year all-cause mortality (hazard ratio 1.55 [95% confidence interval 1.26-1.90] P < 0.001). Moreover, SHR had an incremental effect on various illness scores in predicting ICU all-cause mortality. CONCLUSION SHR is linked to ICU death and 1-year all-cause mortality in critically ill patients, and it has an incremental predictive value in different illness scores. Moreover, we found that non-diabetic patients, rather than diabetic patients, showed an increased risk of all-cause mortality.
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Affiliation(s)
- Chong Zhang
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- Department of Heart Center, The Third Central Hospital of Tianjin, Tianjin, China
| | - He-Chen Shen
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- Department of Heart Center, The Third Central Hospital of Tianjin, Tianjin, China
| | - Wei-Ru Liang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Meng Ning
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- Department of Heart Center, The Third Central Hospital of Tianjin, Tianjin, China
| | - Zi-Xuan Wang
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
| | - Yi Chen
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- Department of Heart Center, The Third Central Hospital of Tianjin, Tianjin, China
| | - Wei Su
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- Department of Heart Center, The Third Central Hospital of Tianjin, Tianjin, China
| | - Ting-Ting Guo
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- Department of Heart Center, The Third Central Hospital of Tianjin, Tianjin, China
| | - Kun Hu
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- Department of Heart Center, The Third Central Hospital of Tianjin, Tianjin, China
| | - Ying-Wu Liu
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, The Third Central Hospital of Tianjin, Tianjin, China
- Artificial Cell Engineering Technology Research Center, The Third Central Hospital of Tianjin, Tianjin, China
- Tianjin Institute of Hepatobiliary Disease, The Third Central Hospital of Tianjin, Tianjin, China
- Department of Heart Center, The Third Central Hospital of Tianjin, Tianjin, China
- *Correspondence: Ying-Wu Liu,
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He J, Xi Y, Lam H, Du K, Chen D, Dong Z, Xiao J. Effect of Intensive Glycemic Control on Myocardial Infarction Outcome in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Diabetes Res 2023; 2023:8818502. [PMID: 36873813 PMCID: PMC9984264 DOI: 10.1155/2023/8818502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND The effect of intensive glucose-lowering treatment on the risk of cardiovascular events in type 2 diabetes remains uncertain, especially the effect on the occurrence of myocardial infarction in patients with type 2 diabetes is still unclear. The purpose of this study was to conduct a systematic review and meta-analysis of relevant RCTs. METHODS We performed a systematic review of randomized clinical trials (RCTS) and observational studies relevant to this study question. We searched the PubMed and Cochrane databases until June 2022. RESULTS We included data on 14 RCTs and 144,334 patients, all of whom had type 2 diabetes. When all studies were considered, intensive glucose-lowering treatment significantly reduced the incidence of MI compared with conventional therapy and the total OR value is 0.90 (CI 0.84, 0.97; P = 0.004) when considering all the studies. When the target value of intensive glucose-lowering treatment was considered as HbA1c decrease of more than 0.5%, there was no significant protective effect on MI, the total OR value is 0.88 (CI 0.81, 0.96; P = 0.003). When considering all available RCTS, the intensive glucose-lowering treatment group had a protective effect for MACE compared to the conventional treatment group, and the total OR value is 0.92 (CI 0.88, 0.96; P < 0.00001). In the available RCTs, for the patients with a history of prior CAD, the total OR value is 0.94 (CI 0.89, 0.99; P = 0.002). And there was no difference in the incidence of hypoglycemic events between the intensive and conservative treatment groups. CONCLUSION Our data support the positive protective effect of glucose-lowering therapy on MI in patients with T2DM, but there is no significant effect of intensive glucose-lowering. In addition, we found no greater protective effect of enhanced glucose control in the HbA1c reduction of more than 0.5%, and no difference in the incidence of adverse events compared with the HbA1c reduction of less than 0.5%.
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Affiliation(s)
- Jiading He
- Department of Cardiology, The Dongguan Affiliated Hospital of Jinan University, Binhaiwan Central Hospital of Dongguan, Dongguan, China
- Department of The First Clinical Medical College, Jinan University, Guangzhou, China
| | - Yangbo Xi
- Department of Cardiology, The Dongguan Affiliated Hospital of Jinan University, Binhaiwan Central Hospital of Dongguan, Dongguan, China
- Department of The First Clinical Medical College, Jinan University, Guangzhou, China
| | - Hingcheung Lam
- Department of Cardiology, The Dongguan Affiliated Hospital of Jinan University, Binhaiwan Central Hospital of Dongguan, Dongguan, China
- Department of The First Clinical Medical College, Jinan University, Guangzhou, China
| | - Keyi Du
- Department of Cardiology, The Dongguan Affiliated Hospital of Jinan University, Binhaiwan Central Hospital of Dongguan, Dongguan, China
- Department of The First Clinical Medical College, Jinan University, Guangzhou, China
| | - Dongping Chen
- Central Laboratory, The Dongguan Affiliated Hospital of Jinan University, Binhaiwan Central Hospital of Dongguan, Dongguan, China
| | - Zhihui Dong
- Central Laboratory, The Dongguan Affiliated Hospital of Jinan University, Binhaiwan Central Hospital of Dongguan, Dongguan, China
| | - Jianmin Xiao
- Department of Cardiology, The Dongguan Affiliated Hospital of Jinan University, Binhaiwan Central Hospital of Dongguan, Dongguan, China
- Central Laboratory, The Dongguan Affiliated Hospital of Jinan University, Binhaiwan Central Hospital of Dongguan, Dongguan, China
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Chen Q, Su H, Yu X, Chen Y, Ding X, Xiong B, Wang C, Xia L, Ye T, Lan K, Hou J, Xiong S, Cai L. The stress hyperglycemia ratio improves the predictive ability of the GRACE score for in-hospital mortality in patients with acute myocardial infarction. Hellenic J Cardiol 2022; 70:36-45. [PMID: 36586422 DOI: 10.1016/j.hjc.2022.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The Global Registry of Acute Coronary Events (GRACE) score is a powerful tool used to predict in-hospital mortality after acute myocardial infarction (AMI) and does not include a glycometabolism-related index. We investigated whether the addition of the stress hyperglycemia ratio (SHR) provides incremental prognostic value in addition to the GRACE score. METHODS A retrospective cohort of 613 AMI patients was enrolled in the present analyses. The patients were stratified according to the primary endpoint (in-hospital mortality) and the tertiles of the SHR. RESULTS During hospitalization, 40 patients reached the primary endpoint, which was more frequently observed in patients with a higher SHR. The SHR, but not admission blood glucose (ABG), adjusted for the GRACE score independently predicted in-hospital mortality [odds ratio 2.5861; 95% confidence interval (CI), 1.3910-4.8080; P = 0.0027]. The adjustment of the GRACE score by the SHR improved the predictive ability for in-hospital death (an increase in the C-statistic value from 0.787 to 0.814; net reclassification improvement, 0.6717, 95% CI 0.3665-0.977, P < 0.01; integrated discrimination improvement, 0.028, 95% CI 0.0066-0.0493, P = 0.01028). The likelihood ratio test showed that the SHR significantly improved the prognostic models, including the GRACE score. Adding the SHR to the GRACE score presented a larger net benefit across the range of in-hospital mortality risk than the GRACE score alone. CONCLUSION The SHR, but not the ABG, is an independent predictor of in-hospital mortality after AMI even after adjusting for the GRACE score. The SHR improves the predictability and clinical usefulness of prognostic models containing the GRACE score.
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Affiliation(s)
- Qiang Chen
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Hong Su
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Xiuqiong Yu
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Yingzhong Chen
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Xunshi Ding
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Bo Xiong
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Chunbin Wang
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Long Xia
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Tao Ye
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Kai Lan
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Jun Hou
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China
| | - Shiqiang Xiong
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China.
| | - Lin Cai
- From Department of Cardiology, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu Cardiovascular Disease Research Institute, Chengdu 610014, Sichuan, China.
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Schamroth Pravda N, Kheifets M, Wiessman M, Leshem-Lev D, Vaknin Assa H, Kornowski R, Talmor-Barkan Y, Perl L. Reticulated Platelets and Their Relationship with Endothelial Progenitor Cells during the Acute Phase of ST-Elevation Myocardial Infarction. J Clin Med 2022; 11:jcm11216597. [PMID: 36362823 PMCID: PMC9655415 DOI: 10.3390/jcm11216597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction: Endothelial progenitor cells (EPC) and reticulated platelets (RP) have central roles in the thrombotic and angiogenetic interactions during ST-elevation myocardial infarction (STEMI). The EPC and RP response in patients with STEMI treated by primary percutaneous intervention (PPCI) has not yet been investigated. Methods: We assessed EPC quantification by the expression of CD133+ and CD34+, and EPC function by the capacity of the cells to form colony-forming units (CFU) and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) during the acute phase of STEMI. These measurements were correlated with RP at baseline and after 24 h following PPCI. Results: Our cohort included 89 consecutive STEMI-diagnosed patients enrolled between December 2018 and July 2021. At baseline, there was a strong positive correlation between reticulated platelet quantity and MTT levels (R = 0.766 and R2 = 0.586, p < 0.001), CD34+ levels (R = 0.602, and R2 = 0.362, p < 0.001); CD133+ levels (R = 0.666 and R2 = 0.443, p < 0.001) and CFU levels (R = 0.437, R2 = 0.191, p < 0.001). The multiple linear regression showed that levels of MTT (adjusted R2 = 0.793; p < 0.001), CD34+ and CD133+ (adjusted R2 = 0.654; p < 0.001 and adjusted R2 = 0.627; p < 0.001, respectively) had strong independent correlations with RP response. At 24 h after PPCI, the correlation between RP quantity and EPC markers was not significant, except for MTT levels (R = 0.465, R2 = 0.216, p < 0.001). Conclusions: In patients with STEMI, higher levels of RP at baseline are significantly correlated with a more potent EPC response. The translational significance of these findings needs further investigation.
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Affiliation(s)
- Nili Schamroth Pravda
- Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence:
| | - Mark Kheifets
- Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Maya Wiessman
- Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Dorit Leshem-Lev
- Felsenstein Medical Research Center, Rabin Medical Center, Petach Tikvah 4941492, Israel
| | - Hana Vaknin Assa
- Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Yeela Talmor-Barkan
- Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Leor Perl
- Department of Cardiology, Rabin Medical Center, Petach Tikva 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Zhao K, Mao Y, Li Y, Yang C, Wang K, Zhang J. The roles and mechanisms of epigenetic regulation in pathological myocardial remodeling. Front Cardiovasc Med 2022; 9:952949. [PMID: 36093141 PMCID: PMC9458904 DOI: 10.3389/fcvm.2022.952949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/10/2022] [Indexed: 11/22/2022] Open
Abstract
Pathological myocardial remodeling was still one of the leading causes of death worldwide with an unmet therapeutic need. A growing number of researchers have addressed the role of epigenome changes in cardiovascular diseases, paving the way for the clinical application of novel cardiovascular-related epigenetic targets in the future. In this review, we summarized the emerged advances of epigenetic regulation, including DNA methylation, Histone posttranslational modification, Adenosine disodium triphosphate (ATP)-dependent chromatin remodeling, Non-coding RNA, and RNA modification, in pathological myocardial remodeling. Also, we provided an overview of the mechanisms that potentially involve the participation of these epigenetic regulation.
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Affiliation(s)
- Kun Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yukang Mao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yansong Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chuanxi Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Cardiology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kai Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Kai Wang
| | - Jing Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Jing Zhang
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22
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Schmitz T, Freuer D, Harmel E, Heier M, Peters A, Linseisen J, Meisinger C. Prognostic value of stress hyperglycemia ratio on short- and long-term mortality after acute myocardial infarction. Acta Diabetol 2022; 59:1019-1029. [PMID: 35532812 PMCID: PMC9242951 DOI: 10.1007/s00592-022-01893-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/09/2022] [Indexed: 01/08/2023]
Abstract
AIMS Prior studies demonstrated an association between hospital admission blood glucose and mortality in acute myocardial infarction (AMI). Because stress hyperglycemia ratio (SHR) has been suggested as a more reliable marker of stress hyperglycemia this study investigated to what extent SHR in comparison with admission blood glucose is associated with short- and long-term mortality in diabetic and non-diabetic AMI patients. METHODS The analysis was based on 2,311 AMI patients aged 25-84 years from the population-based Myocardial Infarction Registry Augsburg (median follow-up time 6.5 years [IQR: 4.9-8.1]). The SHR was calculated as admission glucose (mg/dl)/(28.7 × HbA1c (%)-46.7). Using logistic and COX regression analyses the associations between SHR and admission glucose and mortality were investigated. RESULT Higher admission glucose and higher SHR were significantly and nonlinearly associated with higher 28-day mortality in AMI patients with and without diabetes. In patients without diabetes, the AUC for SHR was significantly lower than for admission glucose (SHR: 0.6912 [95%CI 0.6317-0.7496], admission glucose: 0.716 [95%CI 0.6572-0.7736], p-value: 0.0351). In patients with diabetes the AUCs were similar for SHR and admission glucose. Increasing admission glucose and SHR were significantly nonlinearly associated with higher 5-year all-cause mortality in AMI patients with diabetes but not in non-diabetic patients. AUC values indicated a comparable prediction of 5-year mortality for both measures in diabetic and non-diabetic patients. CONCLUSIONS Stress hyperglycemia in AMI patients plays a significant role mainly with regard to short-term prognosis, but barely so for long-term prognosis, underlining the assumption that it is a transient dynamic disorder that occurs to varying degrees during the acute event, thereby affecting prognosis.
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Affiliation(s)
- T Schmitz
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany.
| | - D Freuer
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
| | - E Harmel
- Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany
| | - M Heier
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
- Institute for Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - A Peters
- Institute for Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - J Linseisen
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - C Meisinger
- Chair of Epidemiology, University of Augsburg, University Hospital Augsburg, Stenglinstraße 2, 86156, Augsburg, Germany
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Marfella R, Federici M, Paolisso G. Editorial: Hyperglycemia and Coronary Artery Diseases: Physio-Pathological Findings and Therapeutic Implications. Front Pharmacol 2022; 13:901815. [PMID: 35662710 PMCID: PMC9161351 DOI: 10.3389/fphar.2022.901815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/20/2022] [Indexed: 01/08/2023] Open
Affiliation(s)
- Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
- Mediterraneo Cardiocentro, Napoli, Italy
| | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
- Mediterraneo Cardiocentro, Napoli, Italy
- *Correspondence: Giuseppe Paolisso,
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24
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González-Juanatey C, Anguita-Sá́nchez M, Barrios V, Núñez-Gil I, Gómez-Doblas JJ, García-Moll X, Lafuente-Gormaz C, Rollán-Gómez MJ, Peral-Disdie V, Martínez-Dolz L, Rodríguez-Santamarta M, Viñolas-Prat X, Soriano-Colomé T, Muñoz-Aguilera R, Plaza I, Curcio-Ruigómez A, Orts-Soler E, Segovia J, Maté C, Cequier Á. Assessment of medical management in Coronary Type 2 Diabetic patients with previous percutaneous coronary intervention in Spain: A retrospective analysis of electronic health records using Natural Language Processing. PLoS One 2022; 17:e0263277. [PMID: 35143527 PMCID: PMC8830700 DOI: 10.1371/journal.pone.0263277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 01/15/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Patients with type 2 diabetes (T2D) and stable coronary artery disease (CAD) previously revascularized with percutaneous coronary intervention (PCI) are at high risk of recurrent ischemic events. We aimed to provide real-world insights into the clinical characteristics and management of this clinical population, excluding patients with a history of myocardial infarction (MI) or stroke, using Natural Language Processing (NLP) technology. METHODS This is a multicenter, retrospective study based on the secondary use of 2014-2018 real-world data captured in the Electronic Health Records (EHRs) of 1,579 patients (0.72% of the T2D population analyzed; n = 217,632 patients) from 12 representative hospitals in Spain. To access the unstructured clinical information in EHRs, we used the EHRead® technology, based on NLP and machine learning. Major adverse cardiovascular events (MACE) were considered: MI, ischemic stroke, urgent coronary revascularization, and hospitalization due to unstable angina. The association between MACE rates and the variables included in this study was evaluated following univariate and multivariate approaches. RESULTS Most patients were male (72.13%), with a mean age of 70.5±10 years. Regarding T2D, most patients were non-insulin-dependent T2D (61.75%) with high prevalence of comorbidities. The median (Q1-Q3) duration of follow-up was 1.2 (0.3-4.5) years. Overall, 35.66% of patients suffered from at least one MACE during follow up. Using a Cox Proportional Hazards regression model analysis, several independent factors were associated with MACE during follow up: CAD duration (p < 0.001), COPD/Asthma (p = 0.021), heart valve disease (p = 0.031), multivessel disease (p = 0.005), insulin treatment (p < 0.001), statins treatment (p < 0.001), and clopidogrel treatment (p = 0.039). CONCLUSIONS Our results showed high rates of MACE in a large real-world series of PCI-revascularized patients with T2D and CAD with no history of MI or stroke. These data represent a potential opportunity to improve the clinical management of these patients.
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Affiliation(s)
| | | | | | - Iván Núñez-Gil
- Hospital Clínico Universitario San Carlos, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ángel Cequier
- Hospital Universitario de Bellvitge and Universidad de Barcelona, IDIBELL, Barcelona, Spain
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25
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Mac Grory B, Piccini JP, Yaghi S, Poli S, De Havenon A, Rostanski SK, Weiss M, Xian Y, Johnston SC, Feng W. Hyperglycemia, Risk of Subsequent Stroke, and Efficacy of Dual Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial. J Am Heart Assoc 2022; 11:e023223. [PMID: 35043692 PMCID: PMC9238477 DOI: 10.1161/jaha.121.023223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background One‐quarter of all strokes are subsequent events. It is not known whether higher levels of blood glucose are associated with an increased risk of subsequent stroke after high‐risk transient ischemic attack or minor ischemic stroke. Methods and Results We performed a secondary analysis of the POINT (Platelet Oriented Inhibition in New TIA and Minor Ischemic Stroke) trial to evaluate the relationship between serum glucose hyperglycemia (≥180 mg/dL) versus normoglycemia (<180 mg/dL) before enrollment in the trial and outcomes at 90 days. The primary end point was subsequent ischemic stroke modeled by a multivariable Cox model with adjustment for age, sex, race, ethnicity, study treatment assignment, index event, and key comorbidities. Of 4878 patients included in this study, 267 had a recurrent stroke. There was a higher hazard of subsequent stroke in patients with hyperglycemia compared with normoglycemia (adjusted hazard ratio [HR], 1.50 [95% CI, 1.05–2.14]). Treatment with dual antiplatelet therapy was not associated with a reduced hazard of subsequent stroke in patients with hyperglycemia (HR, 1.18 [95% CI, 0.69–2.03]), though the wide confidence interval does not exclude a treatment effect. When modeled as a continuous variable, there was evidence of a nonlinear association between serum glucose and the hazard of subsequent stroke (P<0.001). Conclusions Hyperglycemia on presentation is associated with an increased risk of subsequent ischemic stroke after high‐risk transient ischemic attack or minor stroke. A rapid, simple assay of serum glucose may be a useful biomarker to identify patients at particularly high risk of subsequent ischemic stroke. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT0099102.
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Affiliation(s)
- Brian Mac Grory
- Department of Neurology Duke University School of Medicine Durham NC
| | - Jonathan P Piccini
- Division of Cardiology Department of Medicine Duke University School of Medicine Durham NC.,Duke Clinical Research Institute Durham NC
| | - Shadi Yaghi
- Department of Neurology Warren Alpert Medical School of Brown University Providence RI
| | - Sven Poli
- Department of Neurology & Stroke and Hertie Institute for Clinical Brain Research Eberhard Karls University Tübingen Tübingen Germany
| | - Adam De Havenon
- Department of Neurology Yale University School of Medicine New Haven CT
| | - Sara K Rostanski
- Department of Neurology NYU Grossman School of Medicine New York NY
| | - Martin Weiss
- Department of Neurology Duke University School of Medicine Durham NC
| | - Ying Xian
- Department of Neurology Duke University School of Medicine Durham NC.,Duke Clinical Research Institute Durham NC
| | | | - Wuwei Feng
- Department of Neurology Duke University School of Medicine Durham NC
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26
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Wang Y, Tong L, Gu N, Ma X, Lu D, Yu D, Yu N, Zhang J, Li J, Guo X. Association of Sirtuin 1 Gene Polymorphisms with the Risk of Coronary Heart Disease in Chinese Han Patients with Type 2 Diabetes Mellitus. J Diabetes Res 2022; 2022:8494502. [PMID: 35469171 PMCID: PMC9034909 DOI: 10.1155/2022/8494502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 02/18/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
AIMS To explore the associations between polymorphisms in SIRT1 and coronary heart disease (CHD) risk in Chinese Han patients with type 2 diabetes (T2D). METHODS This case-controlled study enrolled 492 patients with T2D: 297 with CHD and 195 without CHD. Five SIRT1 haplotype-tagging single-nucleotide polymorphisms (rs3818291, rs12242965, rs3818292, rs4746720, and rs16924934) were selected from Chinese Han data in the GRCh37.p13 phase 3 database and genotyped by polymerase chain reaction-restriction fraction length polymorphism or sequencing. RESULTS The rs16924934 G allele was associated with a higher risk of CHD than the A allele (odds ratio (OR) = 1.429; 95% confidence interval (CI) = 1.003-2.037; P = 0.048). Using an additive inheritance model, the rs3818291 G/A genotype was associated with a higher CHD risk than the G/G genotype (OR' = 1.683; 95%CI = 1.033-2.743; P' = 0.037 after adjustment for CHD risk factors). Smokers carrying G/A or A/A rs3818291 genotypes had a 3-fold higher CHD risk than those carrying GG (adjusted OR' = 3.035; P' = 0.011) and a 2.6-fold higher CHD risk than nonsmokers carrying GG (adjusted OR' = 2.604; P' = 0.033). CONCLUSIONS Genetic polymorphisms of SIRT1 are associated with the risk of CHD in a Chinese Han population with T2D.
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Affiliation(s)
- Yuxin Wang
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Linchao Tong
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Nan Gu
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Xiaowei Ma
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Difei Lu
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Dahong Yu
- Department of Endocrinology, Peking University First Hospital, Beijing, China
- Department of Endocrinology, Changping District Hospital, Beijing, China
| | - Na Yu
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Junqing Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
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27
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Chen X, Huang F, Liu Y, Liu S, Tan G. Exosomal miR-152-5p and miR-3681-5p function as potential biomarkers for ST-segment elevation myocardial infarction. Clinics (Sao Paulo) 2022; 77:100038. [PMID: 35751950 PMCID: PMC9243048 DOI: 10.1016/j.clinsp.2022.100038] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/21/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The strain parameters of Real-Time Three-Dimensional Spot Tracking Echocardiography (RT3D-STE) are GLS, GAS, GRS, and GCS, while each index can significantly diagnose Acute Myocardial Infarction (AMI) patients, but none of them can distinguish between NSTEMI and STEMI. MicroRNAs (miRNAs) play essential roles in Acute Myocardial Infarction (AMI), but little is known about the value of exosome miRNA combined with Real-Time Three-Dimensional Spot Tracking Echocardiography (RT3D-STE) between ST-segment Elevation Myocardial Infarction (STEMI) and Non-ST-segment Elevation Myocardial Infarction (NSTEMI). AIM To estimate the exosomal miRNAs related to strain parameters of RT3D-STE as biomarkers for early detection of STEMI and NSTEMI. METHODS The present study collected plasma samples from thirty-four (34) patients with AMI (including STEMI and NSTEMI) and employed high-throughput sequence technology and real-time quantitative polymerase chain reaction (RT-qPCR) to identify the differentially expressed miRNAs. The Pearson correlation coefficient is used to measure the strength of a linear association between differentially expressed miRNAs and strain parameters of RT3D-STE. RESULTS Twenty-eight (28) differentially expressed exosomal miRNAs were universally identified between STEMI, NSTEM, and normal groups. Among them, there are 10 miRNAs (miR-152-5p, miR-3681-5p, miR-193a-5p, miR-193b-5p miR-345-5p, miR-125a-5p, miR-365a-3p, miR-4520-2-3p, hsa-miR-193b-3p and hsa-miR-5579-5p) with a Pearson correlation greater than 0.6 with RT3D-STE strain parameters. Especially, miR-152-5p and miR-3681-5p showed the most significant correlation with RT3D-STE strain parameters. Target genes of these 10 miRNAs are analyzed for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enrichment, and they were found to be mainly involved in the cellular metabolism processes and HIF-1 signaling pathway. RT-qPCR verified the significant differential expression of miR-152-5p and miR-3681-5p between STEMI and NSTEM groups. CONCLUSION RT3D-STE and exosome miRNAs can be used as a hierarchical diagnostic system in AMI. If the RT3D-STE is abnormal, the exosome miRNAs can be detected again to obtain more detailed and accurate diagnostic results between STEMI and NSTEM groups. Exosomal miR-152-5p and miR-3681-5p may serve as potential biomarkers for ST-segment elevation myocardial infarction.
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Affiliation(s)
- Xiaozhu Chen
- Department of Ultrasound, People's Hospital of Longhua Shenzhen, Guangdong, China.
| | - Fengrong Huang
- Department of Cardiology, People's Hospital of Longhua Shenzhen, Guangdong, China
| | - Yunhong Liu
- Clinical Laboratory, People's Hospital of Longhua Shenzhen, Guangdong, China
| | - Shujun Liu
- Department of Ultrasound, People's Hospital of Longhua Shenzhen, Guangdong, China
| | - Gangwen Tan
- Department of Cardiology, People's Hospital of Longhua Shenzhen, Guangdong, China
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28
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Xu JJ, Cui J, Lin Q, Chen XY, Zhang J, Gao EH, Wei B, Zhao W. Protection of the enhanced Nrf2 deacetylation and its downstream transcriptional activity by SIRT1 in myocardial ischemia/reperfusion injury. Int J Cardiol 2021; 342:82-93. [PMID: 34403762 DOI: 10.1016/j.ijcard.2021.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/03/2021] [Indexed: 02/08/2023]
Abstract
Nrf2, the master gene transcriptor of antioxidant proteins, and SIRT1, the unique Class III histone deacetylase of sirtuins, have been involved in protecting myocardial ischemia/reperfusion (MI/R) injury. However, whether the protective effect of SIRT1 is directly related to the deacetylation of Nrf2 in the pathology of MI/R remains to be investigated. The current study was designed to evaluate the regulation of Nrf2 deacetylation and transcriptional activity by SIRT1 in MI/R. Hypoxia/reoxygenation (H/R) cardiomyocytes and MI/R mice were used to assess the role of SIRT1 in Nrf2 activation. Oxidative stress, cardiac function, LDH release, ROS and infarct size were also evaluated. We found that Nrf2 physically interacted with SIRT1 not only in normal and H/R cardiomyocytes in vitro, but also in Sham or I/R hearts in vivo. Adenovirus induced SIRT1 overexpression resulted in protected H/R induced cell death, accompanied by declined LDH release. Through MI/R in vivo, cardiac overexpression of SIRT1 led to ameliorated cardiac function and infarct size, as well as the decreased cardiac oxidative stress. Notably, such beneficial actions of SIRT1 were blocked by the Nrf2 silence. Mechanically, acetylation of Nrf2 was significantly decreased by SIRT1 overexpression in cardiomyocytes or in whole hearts, which upregulated the downstream signaling pathway of Nrf2. Taken together, we uncovered a clue, for the first time that SIRT1 physically interacts with Nrf2. The cardioprotective effect of SIRT1 overexpression against MI/R is associated with the increased Nrf2 deacetylation and activity. These findings have offered a direct proof and new perspective of post-translational modification in the understanding of oxidative stress and MI/R treatment.
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Affiliation(s)
- Jia-Jia Xu
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan 450001, PR China
| | - Jing Cui
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan 450001, PR China
| | - Qiao Lin
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan 450001, PR China
| | - Xiu-Ying Chen
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan 450001, PR China
| | - Ji Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, PR China
| | - Er-He Gao
- Center for Translational Medicine, Temple University School of Medicine, MERB, 3500 N. Broad Street, Philadelphia, PA 19140, USA
| | - Bo Wei
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan 450001, PR China.
| | - Wen Zhao
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, School of Pharmaceutical Sciences, Zhengzhou University, No. 100 Kexue Avenue, Zhengzhou, Henan 450001, PR China.
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29
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Wenzl FA, Ambrosini S, Mohammed SA, Kraler S, Lüscher TF, Costantino S, Paneni F. Inflammation in Metabolic Cardiomyopathy. Front Cardiovasc Med 2021; 8:742178. [PMID: 34671656 PMCID: PMC8520939 DOI: 10.3389/fcvm.2021.742178] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/31/2021] [Indexed: 12/24/2022] Open
Abstract
Overlapping pandemics of lifestyle-related diseases pose a substantial threat to cardiovascular health. Apart from coronary artery disease, metabolic disturbances linked to obesity, insulin resistance and diabetes directly compromise myocardial structure and function through independent and shared mechanisms heavily involving inflammatory signals. Accumulating evidence indicates that metabolic dysregulation causes systemic inflammation, which in turn aggravates cardiovascular disease. Indeed, elevated systemic levels of pro-inflammatory cytokines and metabolic substrates induce an inflammatory state in different cardiac cells and lead to subcellular alterations thereby promoting maladaptive myocardial remodeling. At the cellular level, inflammation-induced oxidative stress, mitochondrial dysfunction, impaired calcium handling, and lipotoxicity contribute to cardiomyocyte hypertrophy and dysfunction, extracellular matrix accumulation and microvascular disease. In cardiometabolic patients, myocardial inflammation is maintained by innate immune cell activation mediated by pattern recognition receptors such as Toll-like receptor 4 (TLR4) and downstream activation of the NLRP3 inflammasome and NF-κB-dependent pathways. Chronic low-grade inflammation progressively alters metabolic processes in the heart, leading to a metabolic cardiomyopathy (MC) phenotype and eventually to heart failure with preserved ejection fraction (HFpEF). In accordance with preclinical data, observational studies consistently showed increased inflammatory markers and cardiometabolic features in patients with HFpEF. Future treatment approaches of MC may target inflammatory mediators as they are closely intertwined with cardiac nutrient metabolism. Here, we review current evidence on inflammatory processes involved in the development of MC and provide an overview of nutrient and cytokine-driven pro-inflammatory effects stratified by cell type.
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Affiliation(s)
- Florian A Wenzl
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Samuele Ambrosini
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Shafeeq A Mohammed
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Simon Kraler
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Thomas F Lüscher
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.,Royal Brompton and Harefield Hospitals and Imperial College, London, United Kingdom
| | - Sarah Costantino
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Francesco Paneni
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.,University Heart Center, Cardiology, University Hospital Zurich, Zurich, Switzerland.,Department of Research and Education, University Hospital Zurich, Zurich, Switzerland
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30
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Ding Y, Zhou Y, Ling P, Feng X, Luo S, Zheng X, Little PJ, Xu S, Weng J. Metformin in cardiovascular diabetology: a focused review of its impact on endothelial function. Am J Cancer Res 2021; 11:9376-9396. [PMID: 34646376 PMCID: PMC8490502 DOI: 10.7150/thno.64706] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/30/2021] [Indexed: 02/07/2023] Open
Abstract
As a first-line treatment for diabetes, the insulin-sensitizing biguanide, metformin, regulates glucose levels and positively affects cardiovascular function in patients with diabetes and cardiovascular complications. Endothelial dysfunction (ED) represents the primary pathological change of multiple vascular diseases, because it causes decreased arterial plasticity, increased vascular resistance, reduced tissue perfusion and atherosclerosis. Caused by “biochemical injury”, ED is also an independent predictor of cardiovascular events. Accumulating evidence shows that metformin improves ED through liver kinase B1 (LKB1)/5'-adenosine monophosphat-activated protein kinase (AMPK) and AMPK-independent targets, including nuclear factor-kappa B (NF-κB), phosphatidylinositol 3 kinase-protein kinase B (PI3K-Akt), endothelial nitric oxide synthase (eNOS), sirtuin 1 (SIRT1), forkhead box O1 (FOXO1), krüppel-like factor 4 (KLF4) and krüppel-like factor 2 (KLF2). Evaluating the effects of metformin on endothelial cell functions would facilitate our understanding of the therapeutic potential of metformin in cardiovascular diabetology (including diabetes and its cardiovascular complications). This article reviews the physiological and pathological functions of endothelial cells and the intact endothelium, reviews the latest research of metformin in the treatment of diabetes and related cardiovascular complications, and focuses on the mechanism of action of metformin in regulating endothelial cell functions.
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31
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Tanase DM, Gosav EM, Ouatu A, Badescu MC, Dima N, Ganceanu-Rusu AR, Popescu D, Floria M, Rezus E, Rezus C. Current Knowledge of MicroRNAs (miRNAs) in Acute Coronary Syndrome (ACS): ST-Elevation Myocardial Infarction (STEMI). Life (Basel) 2021; 11:life11101057. [PMID: 34685428 PMCID: PMC8541211 DOI: 10.3390/life11101057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/02/2021] [Accepted: 10/06/2021] [Indexed: 02/06/2023] Open
Abstract
Regardless of the newly diagnostic and therapeutic advances, coronary artery disease (CAD) and more explicitly, ST-elevation myocardial infarction (STEMI), remains one of the leading causes of morbidity and mortality worldwide. Thus, early and prompt diagnosis of cardiac dysfunction is pivotal in STEMI patients for a better prognosis and outcome. In recent years, microRNAs (miRNAs) gained attention as potential biomarkers in myocardial infarction (MI) and acute coronary syndromes (ACS), as they have key roles in heart development, various cardiac processes, and act as indicators of cardiac damage. In this review, we describe the current available knowledge about cardiac miRNAs and their functions, and focus mainly on their potential use as novel circulating diagnostic and prognostic biomarkers in STEMI.
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Affiliation(s)
- Daniela Maria Tanase
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Evelina Maria Gosav
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
- Correspondence: (E.M.G.); (M.F.); (E.R.)
| | - Anca Ouatu
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Minerva Codruta Badescu
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Nicoleta Dima
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Ana Roxana Ganceanu-Rusu
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Diana Popescu
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
| | - Mariana Floria
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, Emergency Military Clinical Hospital Iasi, 700483 Iasi, Romania
- Correspondence: (E.M.G.); (M.F.); (E.R.)
| | - Elena Rezus
- Department of Rheumatology and Physiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- I Rheumatology Clinic, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Correspondence: (E.M.G.); (M.F.); (E.R.)
| | - Ciprian Rezus
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.M.T.); (A.O.); (M.C.B.); (N.D.); (A.R.G.-R.); (D.P.); (C.R.)
- Internal Medicine Clinic, “Sf. Spiridon” County Clinical Emergency Hospital Iasi, 700111 Iasi, Romania
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Zaman F, Ponnapureddy R, Wang YG, Chang A, Cadaret LM, Abdelhamid A, Roy SD, Makan M, Zhou R, Jayanna MB, Gnall E, Dai X, Singh A, Zheng J, Boppana VS, Wang F, Singh P, Wu X, Liu K. Spatio-temporal hybrid neural networks reduce erroneous human "judgement calls" in the diagnosis of Takotsubo syndrome. EClinicalMedicine 2021; 40:101115. [PMID: 34522872 PMCID: PMC8426197 DOI: 10.1016/j.eclinm.2021.101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/08/2021] [Accepted: 08/16/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND We investigate whether deep learning (DL) neural networks can reduce erroneous human "judgment calls" on bedside echocardiograms and help distinguish Takotsubo syndrome (TTS) from anterior wall ST segment elevation myocardial infarction (STEMI). METHODS We developed a single-channel (DCNN[2D SCI]), a multi-channel (DCNN[2D MCI]), and a 3-dimensional (DCNN[2D+t]) deep convolution neural network, and a recurrent neural network (RNN) based on 17,280 still-frame images and 540 videos from 2-dimensional echocardiograms in 10 years (1 January 2008 to 1 January 2018) retrospective cohort in University of Iowa (UI) and eight other medical centers. Echocardiograms from 450 UI patients were randomly divided into training and testing sets for internal training, testing, and model construction. Echocardiograms of 90 patients from the other medical centers were used for external validation to evaluate the model generalizability. A total of 49 board-certified human readers performed human-side classification on the same echocardiography dataset to compare the diagnostic performance and help data visualization. FINDINGS The DCNN (2D SCI), DCNN (2D MCI), DCNN(2D+t), and RNN models established based on UI dataset for TTS versus STEMI prediction showed mean diagnostic accuracy 73%, 75%, 80%, and 75% respectively, and mean diagnostic accuracy of 74%, 74%, 77%, and 73%, respectively, on the external validation. DCNN(2D+t) (area under the curve [AUC] 0·787 vs. 0·699, P = 0·015) and RNN models (AUC 0·774 vs. 0·699, P = 0·033) outperformed human readers in differentiating TTS and STEMI by reducing human erroneous judgement calls on TTS. INTERPRETATION Spatio-temporal hybrid DL neural networks reduce erroneous human "judgement calls" in distinguishing TTS from anterior wall STEMI based on bedside echocardiographic videos. FUNDING University of Iowa Obermann Center for Advanced Studies Interdisciplinary Research Grant, and Institute for Clinical and Translational Science Grant. National Institutes of Health Award (1R01EB025018-01).
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Affiliation(s)
- Fahim Zaman
- Department of Electrical and Electronic Engineering, University of Iowa, Iowa city, IA, United States
| | - Rakesh Ponnapureddy
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, IA, United States
| | - Yi Grace Wang
- Department of Mathematics, California State University Dominguez Hills, Carson, CA, United States
| | - Amanda Chang
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, IA, United States
| | - Linda M Cadaret
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, IA, United States
| | - Ahmed Abdelhamid
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, IA, United States
| | - Shubha D Roy
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, IA, United States
| | - Majesh Makan
- Division of Cardiology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Ruihai Zhou
- Division of Cardiology, Department of Medicine, University of North Carolina, Chapel Hill, United States
| | - Manju B Jayanna
- Division of Cardiology, Department of Medicine, Lankenau Medical Center, Wynnewood, PA, United States
| | - Eric Gnall
- Division of Cardiology, Department of Medicine, Lankenau Medical Center, Wynnewood, PA, United States
| | - Xuming Dai
- Department of Cardiology, New York Presbyterian Queens/Weill Cornell Medical College, New York City, NY, United States
| | - Avneet Singh
- Division of Cardiology, Department of Medicine, State University of New York, Syracuse, NY, United States
| | - Jingsheng Zheng
- Department of Cardiology, AtlaniCare Regional Medical Center, Pomona, NJ, United States
| | - Venkata S Boppana
- Division of Cardiology, Department of Medicine, University of Kansas-Wichita, Wichita, KS, United States
| | - Feng Wang
- Department of Cardiology, Providence Regional Medical Center, Washington State University, Everett, WA, United States
| | - Pahul Singh
- Department of Cardiology, Northwest Health Medical Center, Bentonville, AR, United States
| | - Xiaodong Wu
- Department of Electrical and Electronic Engineering, University of Iowa, Iowa city, IA, United States
- Corresponding authors.
| | - Kan Liu
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, IA, United States
- Corresponding authors.
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Paolisso P, Foà A, Bergamaschi L, Angeli F, Fabrizio M, Donati F, Toniolo S, Chiti C, Rinaldi A, Stefanizzi A, Armillotta M, Sansonetti A, Magnani I, Iannopollo G, Rucci P, Casella G, Galiè N, Pizzi C. Impact of admission hyperglycemia on short and long-term prognosis in acute myocardial infarction: MINOCA versus MIOCA. Cardiovasc Diabetol 2021; 20:192. [PMID: 34560876 PMCID: PMC8464114 DOI: 10.1186/s12933-021-01384-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/10/2021] [Indexed: 01/08/2023] Open
Abstract
Background The prognostic role of hyperglycemia in patients with myocardial infarction and obstructive coronary arteries (MIOCA) is acknowledged, while data on non-obstructive coronary arteries (MINOCA) are still lacking. Recently, we demonstrated that admission stress-hyperglycemia (aHGL) was associated with a larger infarct size and inflammatory response in MIOCA, while no differences were observed in MINOCA. We aim to investigate the impact of aHGL on short and long-term outcomes in MIOCA and MINOCA patients. Methods Multicenter, population-based, cohort study of the prospective registry, designed to evaluate the prognostic information of patients admitted with acute myocardial infarction to S. Orsola-Malpighi and Maggiore Hospitals of Bologna metropolitan area. Among 2704 patients enrolled from 2016 to 2020, 2431 patients were classified according to the presence of aHGL (defined as admission glucose level ≥ 140 mg/dL) and AMI phenotype (MIOCA/MINOCA): no-aHGL (n = 1321), aHGL (n = 877) in MIOCA and no-aHGL (n = 195), aHGL (n = 38) in MINOCA. Short-term outcomes included in-hospital death and arrhythmias. Long-term outcomes were all-cause and cardiovascular mortality. Results aHGL was associated with a higher in-hospital arrhythmic burden in MINOCA and MIOCA, with increased in-hospital mortality only in MIOCA. After adjusting for age, gender, hypertension, Killip class and AMI phenotypes, aHGL predicted higher in-hospital mortality in non-diabetic (HR = 4.2; 95% CI 1.9–9.5, p = 0.001) and diabetic patients (HR = 3.5, 95% CI 1.5–8.2, p = 0.003). During long-term follow-up, aHGL was associated with 2-fold increased mortality in MIOCA and a 4-fold increase in MINOCA (p = 0.032 and p = 0.016). Kaplan Meier 3-year survival of non-hyperglycemic patients was greater than in aHGL patients for both groups. No differences in survival were found between hyperglycemic MIOCA and MINOCA patients. After adjusting for age, gender, hypertension, smoking, LVEF, STEMI/NSTEMI and AMI phenotypes (MIOCA/MINOCA), aHGL predicted higher long-term mortality. Conclusions aHGL was identified as a strong predictor of adverse short- and long-term outcomes in both MIOCA and MINOCA, regardless of diabetes. aHGL should be considered a high-risk prognostic marker in all AMI patients, independently of the underlying coronary anatomy. Trial registration data were part of the ongoing observational study AMIPE: Acute Myocardial Infarction, Prognostic and Therapeutic Evaluation. ClinicalTrials.gov Identifier: NCT03883711. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01384-6.
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Affiliation(s)
- Pasquale Paolisso
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Alberto Foà
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Luca Bergamaschi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Francesco Angeli
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Michele Fabrizio
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Francesco Donati
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Sebastiano Toniolo
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Chiara Chiti
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Andrea Rinaldi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Andrea Stefanizzi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Matteo Armillotta
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Angelo Sansonetti
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Ilenia Magnani
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | | | - Paola Rucci
- Division of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Nazzareno Galiè
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Carmine Pizzi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, IRCCS Policlinico S. Orsola - Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy.
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Wang H, He F, Liang B, Jing Y, Zhang P, Liu W, Zhu B, Dou D. LincRNA-p21 alleviates atherosclerosis progression through regulating the miR-221/SIRT1/Pcsk9 axis. J Cell Mol Med 2021; 25:9141-9153. [PMID: 34541816 PMCID: PMC8500963 DOI: 10.1111/jcmm.16771] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 06/11/2021] [Accepted: 06/19/2021] [Indexed: 02/06/2023] Open
Abstract
Atherosclerosis (AS) is the main aetiology of coronary heart disease, cerebral infarction and peripheral vascular disease in humans. Long‐noncoding RNA (LincRNA)‐p21 has been reported to participate in the development of AS. Therefore, this study was designed to investigate the mechanism of LincRNA‐p21 on suppressing the development of AS. We fed ApoE−/− mice with a high‐fat diet to induce an AS mouse model where the lesion area of AS and the extent of lipid deposition were measured. The binding of LincRNA‐p21 and miR‐221 or miR‐221 and SIRT1 was measured using a dual luciferase reporter gene assay and RIP. Following loss‐ and gain‐ function assays, CCK8, EdU, Transwell assay and scratch test were performed to determine the biological processes of human aortic endothelial cells (HAECs). miR‐221 was highly expressed while SIRT1 was poorly expressed in AS. LincRNA‐p21 acted as a sponge for miR‐221. miR‐221 targeted and negatively regulated the expression of SIRT1. LincRNA‐p21 promoted the deacetylation of Pcsk9 by SIRT1 by competitively binding to miR‐221, whereby promoting HAEC proliferation, migration and tube formation. In conclusion, LincRNA‐p21 acted as a molecular sponge for miR‐221 to promote deacetylation of the promoter region of Pcsk9 by SIRT1, therefore preventing the development of AS.
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Affiliation(s)
- Haojie Wang
- Thoracic & Cardiovascular Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Fei He
- Thoracic & Cardiovascular Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Bing Liang
- Thoracic & Cardiovascular Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Yuanhu Jing
- Thoracic & Cardiovascular Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Pei Zhang
- Thoracic & Cardiovascular Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Weichao Liu
- Thoracic & Cardiovascular Surgery, Huaihe Hospital of Henan University, Kaifeng, China
| | - Bowen Zhu
- School of Clinical Medicine, Henan University, Kaifeng, China
| | - Dongmei Dou
- Institute of Chronic Disease Risks Assessment, Henan University, Kaifeng, China
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D'Onofrio N, Sardu C, Trotta MC, Scisciola L, Turriziani F, Ferraraccio F, Panarese I, Petrella L, Fanelli M, Modugno P, Massetti M, Marfella LV, Sasso FC, Rizzo MR, Barbieri M, Furbatto F, Minicucci F, Mauro C, Federici M, Balestrieri ML, Paolisso G, Marfella R. Sodium-glucose co-transporter2 expression and inflammatory activity in diabetic atherosclerotic plaques: Effects of sodium-glucose co-transporter2 inhibitor treatment. Mol Metab 2021; 54:101337. [PMID: 34500107 PMCID: PMC8473552 DOI: 10.1016/j.molmet.2021.101337] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 12/19/2022] Open
Abstract
Objective We evaluated sodium-glucose co-transporter2 (SGLT2) expression and the effect of SGLT2 inhibitor (SGLT2i) therapies on carotid plaques of asymptomatic diabetic and non-diabetic patients. Methods Plaques were obtained from 296 non-diabetic patients and 227 patients with type 2 diabetes undergoing carotid endarterectomy. 97 patients with type 2 diabetes were treated with SGLT2 inhibitors for 16 ± 4 months before endarterectomy. After propensity score matching analysis, patients with type 2 diabetes were categorized without (n = 87) and with SGLT2i therapy (n = 87). To investigate SGLT2 expression levels' effects on major adverse endpoints (MACE = stroke, transient ischemic attack, myocardial infarction, and death), we evaluated MACE outcomes at a 2-year follow-up. Results Compared to plaques from patients without diabetes, plaques from patients with diabetes had higher SGLT2 expression, inflammation, and oxidative stress, along with lower SIRT6 expression and collagen content. Compared with plaques from patients with diabetes, SGLT2i-treated patients with type 2 diabetes presented increased SIRT6 expression and collagen content and lowered inflammation and ion and oxidative stress, thus indicating a more stable plaque phenotype. These results supported in vitro observations on human aorta endothelial cells (EC) (TeloHAEC-cells). Indeed, EC treated with high glucose (25 mM) in the presence of SGLT2i (100 nM canagliflozin) presented higher SIRT6 expression and decreased mRNA and protein SGLT2 levels, nuclear factor-kappa B (NF-B(NF-κB), and matrix metallopeptidase 9 (MMP-9) expression compared to cells treated only with high glucose. After two years following endarterectomy, a multivariable Cox regression analysis showed significantly higher 2-year overall survival from MACE in patients without diabetes (P < 0.01). Among patient with diabetes, the current SGLT2i users presented a significantly lower rate of MACE through 2 years compared to non-SGLT2i users (P < 0.05). Conclusions These findings unveil a critical involvement of the SGLT2/SIRT6 pathway in the inflammatory process of diabetic atherosclerotic lesions and suggest its possible favorable modulation by SGLT2i. The identification of novel molecular targets of atherosclerosis progression is of utmost importance in diabetic patients. The occurrence of SGLT2 receptors on the endothelial cells of atherosclerotic plaques may be an attractive therapeutic option for atherosclerosis in patients with diabetes. SGLT2/SIRT6 represents an attractive option, given its crucial involvement in atherosclerosis progression. The endothelial SGLT2 inhibition increases the endothelial expression of SIRT6, yielding an improved atherosclerotic plaque phenotype and 2-year outcome. The impairment of the endothelial SGLT2/SIRT6 pathway worsens outcomes in atherosclerotic patients with diabetes; this may be a potential preventive target.
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Affiliation(s)
- Nunzia D'Onofrio
- Department of Precision Medicine, the University of Campania "Luigi Vanvitelli,", Italy
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Italy
| | - Maria Consiglia Trotta
- Department of Experimental Medicine, Section of Pharmacology, University of Campania "Luigi Vanvitelli,", Italy
| | - Lucia Scisciola
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Italy
| | - Fabrizio Turriziani
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Italy
| | - Franca Ferraraccio
- Department of Mental Health and Public Medicine, Section of Statistic, the University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Iacopo Panarese
- Department of Mental Health and Public Medicine, Section of Statistic, the University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - Lella Petrella
- Laboratory of Molecular Oncology, Gemelli Molise SpA, Campobasso, Italy
| | - Mara Fanelli
- Department of Cardiovascular Medicine, Gemelli Molise SpA, Campobasso, Italy
| | - Piero Modugno
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Massimo Massetti
- Department of Cardiovascular Medicine, Gemelli Molise SpA, Campobasso, Italy
| | | | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Italy
| | - Maria Rosaria Rizzo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Italy
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Italy
| | - Fulvio Furbatto
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Fabio Minicucci
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Ciro Mauro
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Italy; Mediterranea Cardiocentro, Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli,", Italy; Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Li JF, Lin ZW, Chen CX, Liang SQ, Du LL, Qu X, Gao Z, Huang YH, Kong ST, Chen JX, Sun LY, Zhou H. Clinical Impact of Thrombus Aspiration and Interaction With D-Dimer Levels in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Front Cardiovasc Med 2021; 8:706979. [PMID: 34447791 PMCID: PMC8383487 DOI: 10.3389/fcvm.2021.706979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate the effect of thrombus aspiration (TA) strategy on the outcomes and its interaction with D-dimer levels in patients with ST-segment elevation myocardial infarction (STEMI) during primary percutaneous coronary intervention (PCI) in "real-world" settings. Materials and Methods: This study included 1,295 patients with STEMI who had undergone primary PCI with or without TA between January 2013 and June 2017. Patients were first divided into a TA+PCI group and a PCI-only group, and the baseline characteristics and long-term mortality between the two groups were analyzed. Furthermore, we studied the effect of TA on the clinical outcomes of patients grouped according to quartiles of respective D-dimer levels. The primary outcome was all-cause mortality, and the secondary outcomes were new-onset heart failure (HF), rehospitalization, re-PCI, and stroke. Results: In the original cohort, there were no significant differences in all-cause mortality between the TA+PCI and PCI-only groups (hazard ratio, 0.789; 95% confidence interval, 0.556-1.120; p = 0.185). After a mean follow-up of 2.5 years, the all-cause mortality rates of patients in the TA + PCI and PCI-only groups were 8.5 and 16.2%, respectively. Additionally, differences between the two groups in terms of the risk of HF, re-PCI, rehospitalization, and stroke were non-significant. However, after dividing into quartiles, as the D-dimer levels increased, the all-cause mortality rate in the PCI group gradually increased (4.3 vs. 6.0 vs. 7.0 vs. 14.7%, p < 0.001), while the death rate in the TA+PCI group did not significantly differ (4.6 vs. 5.0 vs. 4.0 vs. 3.75%, p = 0.85). Besides, in the quartile 3 (Q3) and quartile 4 (Q4) groups, the PCI-only group was associated with a higher risk of all-cause mortality than that of the TA+PCI group (Q3: 4.0 vs. 7.0%, p = 0.029; Q4: 3.75 vs. 14.7%, p < 0.001). Moreover, the multivariate logistic regression analysis demonstrated that TA is inversely associated with the primary outcome in the Q4 group [odds ratio (OR), 0.395; 95% CI, 0.164-0.949; p = 0.038]. Conclusions: The findings of our real-world study express that routine manual TA during PCI in STEMI did not improve clinical outcomes overall. However, patients with STEMI with a higher concentration of D-dimer might benefit from the use of TA during primary PCI. Large-scale studies are recommended to confirm the efficacy of TA.
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Affiliation(s)
- Jun-Feng Li
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhi-Wei Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chang-Xi Chen
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shi-Qi Liang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lei-Lei Du
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiang Qu
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhan Gao
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yu-Heng Huang
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shu-Ting Kong
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jin-Xin Chen
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ling-Yue Sun
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Zhou
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Badacz R, Kleczyński P, Legutko J, Żmudka K, Gacoń J, Przewłocki T, Kabłak-Ziembicka A. Expression of miR-1-3p, miR-16-5p and miR-122-5p as Possible Risk Factors of Secondary Cardiovascular Events. Biomedicines 2021; 9:biomedicines9081055. [PMID: 34440258 PMCID: PMC8391895 DOI: 10.3390/biomedicines9081055] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/05/2021] [Accepted: 08/16/2021] [Indexed: 01/13/2023] Open
Abstract
Ischemic event in one arterial territory increases the risk of a subsequent ischemic event. Circulating microRNAs (miRs) emerge as a potential clinical tool to assess risk of subsequent atherothrombotic events such as cardiovascular death (CVD), myocardial infarction (MI) and ischemic stroke (IS). In this prospective study, we searched for athero-specific miRs related to cardiovascular event risk in patients with symptomatic coronary, carotid lesion, or both territories involvements. The choice of particular miRs was based on database research (Pub-Med, Bethesda, MD, USA) taking into consideration the relationship with development of atherosclerosis and potential prognostic value. Levels of circulating miRs (miR-1-3p, miR-16-5p, miR-34a-5p, mir-122-5p, miR-124-3p, miR-133a-3p, miR-133b, miR-134-5p, miR-208b-3p, miR-375 and miR-499-5p) were compared in 142 patients with an acute ischemic event resulting from carotid and/or coronary artery stenosis, who underwent revascularization for symptomatic lesion. A 6-year prospective evaluation of CVD/MI/IS risk was performed. Patients with two-territory as compared to single-territory involvement differed in levels of miR-1-3p (p = 0.016), miR-16-5p (p < 0.001), miR-34a-5p (p = 0.018), miR-122-5p (p = 0.007), miR-124-3p (p < 0.001) and miR-499-5p (p < 0.001). During follow-up, 62 (43.7%) episodes of CVD/MI/IS occurred. In multivariate Cox analysis, miR-122-5p (HR = 1.0006, 95%CI = 1.0001–1.0011) and peripheral artery disease (PAD) (HR = 2.16, 95%CI = 1.26–3.70) were associated with CVD/MI/IS risk; miR-1-3p (HR = 2.73, 95%CI = 1.22–6.12) and PAD (HR = 3.47, 95%CI = 1.88–6.41) with CVD; miR-122-5p (HR = 1.0001, 95%CI = 1.000–1.0002) and creatinine level (HR = 1.02, 95%CI = 1.01–1.04) with IS, and miR-16-5p (HR = 1.0004, 95%CI = 1.0001–1.0008) with MI. Expression of miR-1-3p, miR-16-5p and miR-122-5p during incident ischemia may be possible risk factors of secondary cardiovascular event(s).
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Affiliation(s)
- Rafał Badacz
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland; (R.B.); (P.K.); (J.L.); (K.Ż.); (J.G.); (T.P.)
| | - Paweł Kleczyński
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland; (R.B.); (P.K.); (J.L.); (K.Ż.); (J.G.); (T.P.)
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland; (R.B.); (P.K.); (J.L.); (K.Ż.); (J.G.); (T.P.)
| | - Krzysztof Żmudka
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland; (R.B.); (P.K.); (J.L.); (K.Ż.); (J.G.); (T.P.)
| | - Jacek Gacoń
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland; (R.B.); (P.K.); (J.L.); (K.Ż.); (J.G.); (T.P.)
- Department of Invasive Cardiology, E. Szczeklik’s Hospital, 33-100 Tarnow, Poland
| | - Tadeusz Przewłocki
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland; (R.B.); (P.K.); (J.L.); (K.Ż.); (J.G.); (T.P.)
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland
| | - Anna Kabłak-Ziembicka
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland; (R.B.); (P.K.); (J.L.); (K.Ż.); (J.G.); (T.P.)
- Noninvasive Cardiovascular Laboratory, John Paul II Hospital, 31-202 Krakow, Poland
- Correspondence:
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Sardu C, D’Onofrio N, Torella M, Portoghese M, Mureddu S, Loreni F, Ferraraccio F, Panarese I, Trotta MC, Gatta G, Galdiero M, Sasso FC, D’Amico M, De Feo M, Balestrieri ML, Paolisso G, Marfella R. Metformin Therapy Effects on the Expression of Sodium-Glucose Cotransporter 2, Leptin, and SIRT6 Levels in Pericoronary Fat Excised from Pre-Diabetic Patients with Acute Myocardial Infarction. Biomedicines 2021; 9:biomedicines9080904. [PMID: 34440108 PMCID: PMC8389537 DOI: 10.3390/biomedicines9080904] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE pericoronary fat over-inflammation might lead to the development and destabilization of coronary plaque in patients with pre-diabetes (PDM). Notably, pericoronary fat could over-express the sodium-glucose cotransporter 2 (SGLT2) and leptin, along with decreased sirtuin 6 (SIRT6) expression in PDM vs. normoglycemic (NG) patients undergoing coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). However, in the current study, we evaluated inflammatory markers, SGLT2, SIRT6, and leptin levels in pericoronary fat and, subsequently, 12-month prognosis comparing PDM to NG subjected to CABG for AMI. In addition, we evaluated in PDM patients the effects of metformin therapy on SIRT6 expression, leptin, and SGLT2 levels, and assessed its beneficial effect on nitrotyrosine and inflammatory cytokine levels. METHODS we studied AMI patients referred for CABG, divided into PDM and NG-patients. PDM patients were divided into never-metformin users and metformin users. Finally, we evaluated major adverse cardiac events (MACE) at a 12-month follow-up. RESULTS the MACE was 9.1% in all PDM and 3% in NG patients (p < 0.05). Metformin users presented a significantly lower MACE rate in PDM than never-metformin users (p < 0.05). PDM showed higher inflammatory cytokines, 3-nitrotyrosine levels, SGLT2, and leptin content, and decreased SIRT6 protein levels in pericoronary fat compared to NG-patients (p < 0.05). PDM never-metformin-users showed higher SGLT2 and leptin levels in pericoronary fat than current-metformin-users (p < 0.05). CONCLUSIONS metformin therapy might ameliorate cardiovascular outcomes by reducing inflammatory parameters, SGLT2, and leptin levels, and finally improving SIRT6 levels in AMI-PDM patients treated with CABG.
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Affiliation(s)
- Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.S.); (G.P.); (R.M.)
- Correspondence: ; Tel.: +39-0815665110; Fax: +39-0815665303
| | - Nunzia D’Onofrio
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (N.D.); (M.L.B.)
| | - Michele Torella
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.T.); (F.L.); (F.F.); (I.P.); (M.D.F.)
| | - Michele Portoghese
- Department of Cardiac Surgery, Santissima Annunziata Hospital, 07100 Sassari, Italy; (M.P.); (S.M.)
| | - Simone Mureddu
- Department of Cardiac Surgery, Santissima Annunziata Hospital, 07100 Sassari, Italy; (M.P.); (S.M.)
| | - Francesco Loreni
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.T.); (F.L.); (F.F.); (I.P.); (M.D.F.)
| | - Franca Ferraraccio
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.T.); (F.L.); (F.F.); (I.P.); (M.D.F.)
| | - Iacopo Panarese
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.T.); (F.L.); (F.F.); (I.P.); (M.D.F.)
| | - Maria Consiglia Trotta
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (G.G.); (M.G.); (M.D.)
| | - Gianluca Gatta
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (G.G.); (M.G.); (M.D.)
| | - Marilena Galdiero
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (G.G.); (M.G.); (M.D.)
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.S.); (G.P.); (R.M.)
| | - Michele D’Amico
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (G.G.); (M.G.); (M.D.)
| | - Marisa De Feo
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.T.); (F.L.); (F.F.); (I.P.); (M.D.F.)
| | - Maria Luisa Balestrieri
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (N.D.); (M.L.B.)
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.S.); (G.P.); (R.M.)
- Mediterranea Cardiocentro, 80122 Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.S.); (G.P.); (R.M.)
- Mediterranea Cardiocentro, 80122 Naples, Italy
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Mandraffino G, Lo Gullo A, Cinquegrani M, D’Ascola A, Sinicropi D, Imbalzano E, Blando G, Campo GM, Morace C, Giuffrida C, Campo S, Squadrito G, Scuruchi M. Expression and Change of miRs 145, 221 and 222 in Hypertensive Subjects Treated with Enalapril, Losartan or Olmesartan. Biomedicines 2021; 9:biomedicines9080860. [PMID: 34440064 PMCID: PMC8389596 DOI: 10.3390/biomedicines9080860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 02/07/2023] Open
Abstract
miR profile could be associated to CV risk, and also to prognosis/outcome in response to therapeutic approach. We aimed to evaluate if anti-hypertensive drugs enalapril, losartan or olmesartan have effects on monocyte miR profile in essential hypertensives without target organ involvement. For this purpose, 82 hypertensives and 49 controls were included; we evaluated SBP/DBP, lipid profile, glucose, CRP, fibrinogen, arterial stiffness indices (PWV; AIx), and cIMT at baseline (T0) and after 24 weeks of treatment (T1). Subjects with LDL-C ≥ 160 mg/dL, TG ≥ 200 mg/dL, BMI ≥ 30, and other additional CV risk factors were excluded. Patients who were prescribed to receive once-a-day enalapril 20 mg, losartan 100 mg or olmesartan 20 mg were eligible for the study. At T1, we found a significant improvement of SBP (-18.5%), DBP (-18%), HDL-C and LDL-C (+3% and -5.42%), glucose (-2.15%), BMI (-3.23%), fibrinogen (-11%), CRP (-17.5%,), AIx (-49.1%) PWV (-32.2%), and monocyte miR expression (miR-221: -28.4%; miR-222: -36%; miR-145: +41.7%) with respect to baseline. miR profile was compared to control subjects at baseline and at T1. We found some little difference in the behaviour of the three treatments on some variables: olmesartan was the most effective in reducing fibrinogen, DBP, CRP, and AIx (-13.1%, -19.3%, -21.4%, and -56.8%, respectively). Enalapril was the drug more significantly increasing the expression of miR-145. In conclusion, enalapril, losartan and olmesartan are effective in improving mechanical and humoral factors associated to AS and atherogenesis. These drugs appear to be able to modify miRs 221/222 and miR-145 expression in drug-naïve hypertensives, making it closer to that of control subjects; additionally, this provides a good blood pressure compensation, contributing to slow the progression of vascular damage.
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Affiliation(s)
- Giuseppe Mandraffino
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
- Lipid Center, Internal Medicine Unit, University of Messina, 98122 Messina, Italy;
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (A.D.); (G.M.C.)
- Correspondence: (G.M.); (A.L.G.)
| | - Alberto Lo Gullo
- IRCCS Neurolesi Bonino Pulejo, 98123 Messina, Italy;
- Correspondence: (G.M.); (A.L.G.)
| | - Maria Cinquegrani
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Angela D’Ascola
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (A.D.); (G.M.C.)
| | - Davide Sinicropi
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Egidio Imbalzano
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Giuseppe Blando
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Giuseppe Maurizio Campo
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (A.D.); (G.M.C.)
| | - Carmela Morace
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | | | - Salvatore Campo
- Laboratory of Molecular Biology, Department of Biomedical and Dental Sciences and Morphofunctional Images, University of Messina, 98122 Messina, Italy;
| | - Giovanni Squadrito
- Internal Medicine Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (M.C.); (D.S.); (E.I.); (G.B.); (C.M.); (G.S.)
| | - Michele Scuruchi
- Lipid Center, Internal Medicine Unit, University of Messina, 98122 Messina, Italy;
- Laboratory of Clinical Biochemistry, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy; (A.D.); (G.M.C.)
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Zhao X, Lan J, Yu X, Zhou J, Tan Y, Sheng Z, Li J, Wang Y, Chen R, Liu C, Zhou P, Chen Y, Song L, Zhao H, Yan H. Primary Percutaneous Coronary Intervention in Patients With Type 2 Diabetes With Late/Very Late Stent Thrombosis and de novo Lesions: A Single-Center Observational Cohort Study of Clinical Outcomes and Influencing Factors. Front Cardiovasc Med 2021; 8:653467. [PMID: 34239902 PMCID: PMC8258412 DOI: 10.3389/fcvm.2021.653467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background: This study compared differences in the risk factors and clinical outcomes of primary percutaneous coronary intervention (PCI) in type 2 diabetes mellitus (DM) and non-DM patients with de novo lesions (DNLs) and late or very late stent thrombosis (LST/VLST). Methods: We used angiography to screen 4,151 patients with acute coronary syndrome for DNL and LST/VLST lesions. Overall, 3,941 patients were included in the analysis and were allocated to the DM (n = 1,286) or non-DM (n = 2,665) group at admission. The primary endpoint was a composite of major adverse cardiovascular events (MACEs), defined as death, myocardial infarction, revascularization, and ischemic stroke, within a median follow-up period of 698 days. Results: In the group with a total white blood cell count >10 × 109/L (P = 0.004), a neutral granular cell count >7 × 109/L (P = 0.030), and neutrophil–lymphocyte ratio >1.5 (P = 0.041), revascularization was better for DNL than for LST/VLST lesions. Among DM patients with DNLs, each unit increase in age was associated with a 53.6% increase in the risk of MACEs [hazard ratio (HR): 1.536, 95% confidence interval (CI), 1.300–1.815, P < 0.0001]. Older age (≥65 years) was associated with a significantly greater risk of MACEs (P < 0.0001). Furthermore, each standard deviation (SD) increase in the level of peak white blood cell counts was associated with a 50.1% increase in the risk of MACEs (HR, 1.501; 95% CI, 1.208–1.864; P = 0.0002). When stratifying the DM population with DNLs according to the D-dimer baseline and peak levels <0.5 vs. ≥0.5 mg/L, the high D-dimer group at baseline had a 2.066-fold higher risk of MACEs (P < 0.0001), and the high peak level D-dimer group had a 1.877-fold higher risk of MACEs (P = 0.001) compared to the low-level groups. Among DM patients with LST/VLST, each unit increase in age was associated with a 75.9% increase in the risk of MACEs (HR: 1.759, 95% CI, 1.052–2.940, P = 0.032). Furthermore, for each SD increase in the peak D-dimer level, the risk of MACEs increased by 59.7% (HR, 1.597; 95% CI, 1.110–2.295; P = 0.041). Conclusion: Following successful primary PCI, the measurement of baseline and peak D-dimer values may help identify individuals at high cardiovascular risk. This suggests a potential benefit of lowering D-dimer levels among T2DM patients with DNL. Furthermore, age and the peak D-dimer values may facilitate the risk stratification of T2DM patients with LST/VLST.
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Affiliation(s)
- Xiaoxiao Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Jun Lan
- Department of Cardiovascular Medicine and Dongguan Cardiovascular Institute, Songshan Lake (SSL) Central Hospital of Dongguan City, The Third People's Hospital of Dongguan City, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, China
| | - Xiaoping Yu
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
| | - Jinying Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Yu Tan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China.,Peking Union Medical College and Chinese Academy of Medical Sciences, Xiamen University, Fujian, China
| | - Zhaoxue Sheng
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Jiannan Li
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Ying Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Runzhen Chen
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Chen Liu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Peng Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Yi Chen
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Li Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China
| | - Hanjun Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China.,Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China
| | - Hongbing Yan
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China.,Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China.,Department of Cardiovascular Medicine and Dongguan Cardiovascular Institute, Songshan Lake (SSL) Central Hospital of Dongguan City, The Third People's Hospital of Dongguan City, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, China
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The Inflammasome Signaling Pathway Is Actively Regulated and Related to Myocardial Damage in Coronary Thrombi from Patients with STEMI. Mediators Inflamm 2021; 2021:5525917. [PMID: 34135690 PMCID: PMC8178014 DOI: 10.1155/2021/5525917] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/07/2021] [Accepted: 05/07/2021] [Indexed: 12/11/2022] Open
Abstract
Background The Nod-Like-Receptor-Protein-3 (NLRP3) inflammasome and the Interleukin-6 (IL-6) pathways are central mechanisms of the inflammatory response in myocardial reperfusion injury. Expanding our knowledge about the inflammasome signaling axis is important to improve treatment options. In a cross-sectional study, we aimed to study presence, localization, and genetic expression of inflammasome- and IL-6- signaling-related proteins in coronary thrombi and circulating leukocytes from ST-elevation myocardial infarction (STEMI) patients, with relation to myocardial injury and time from symptoms to PCI. Methods Intracoronary thrombi were aspirated from 33 STEMI patients. Blood samples were drawn. mRNA of Toll-Like-Receptor-4 (TLR4), NLRP3, caspase 1, Interleukin-1β (IL1-β), Interleukin-18 (IL-18), IL-6, IL-6-receptor (IL-6R), and glycoprotein 130 (gp130) were isolated from thrombi and circulating leukocytes and relatively quantified by RT-PCR. A part of each thrombus was embedded in paraffin for histology and immunohistochemistry analyses. Results Genes encoding the 8 markers were present in 76-100% of thrombi. Expression of TLR4 in thrombi significantly correlated to troponin T (r = 0.455, p = 0.013), as did NLRP3 (r = 0.468, p = 0.024). Troponin T correlated with expression in circulating leukocytes of TLR4 (r = 0.438, p = 0.011), NLRP3 (r = 0.420, p = 0.0149), and IL-1β (r = 0.394, p = 0.023). IL-6R expression in thrombi correlated significantly to troponin T (r = 0.434, p = 0.019), whereas gp130 was inversely correlated (r = −0.398, p = 0.050). IL-6 in circulating leukocytes correlated inversely to troponin T (r = −0.421, p = 0.015). There were no significant correlations between genes expressed in thrombi and time from symptom to PCI. Conclusions The inflammasome signaling pathway was actively regulated in coronary thrombi and in circulating leukocytes from patients with STEMI, in association with myocardial damage measured by troponin T. This supports the strategy of medically targeting this pathway in treating myocardial infarction and contributes to sort out optimal timing and targets for anti-inflammatory treatment. The study is registered at clinicaltrials.gov with identification number NCT02746822.
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Li M, Chen G, Feng Y, He X. Stress Induced Hyperglycemia in the Context of Acute Coronary Syndrome: Definitions, Interventions, and Underlying Mechanisms. Front Cardiovasc Med 2021; 8:676892. [PMID: 34055942 PMCID: PMC8149624 DOI: 10.3389/fcvm.2021.676892] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/19/2021] [Indexed: 01/08/2023] Open
Abstract
Elevation of glucose level in response to acute coronary syndrome (ACS) has been recognized as stress induced hyperglycemia (SIH). Plenty of clinical studies have documented that SIH occurs very common in patients hospitalized with ACS, even in those without previously known diabetes mellitus. The association between elevated blood glucose levels with adverse outcome in the ACS setting is well-established. Yet, the precise definition of SIH in the context of ACS remains controversial, bringing confusions about clinical management strategy. Several randomized trials aimed to evaluate the effect of insulin-based therapy on outcomes of ACS patients failed to demonstrate a consistent benefit of intensive glucose control. Mechanisms underlying detrimental effects of SIH on patients with ACS are undetermined, oxidative stress might play an important role in the upstream pathways leading to subsequent harmful effects on cardiovascular system. This review aims to discuss various definitions of SIH and their values in predicting adverse outcome in the context of ACS, as well as the effect of intensive glucose control on clinical outcome. Finally, a glimpse of the underlying mechanisms is briefly discussed.
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Affiliation(s)
- Mingmin Li
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guo Chen
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yingqing Feng
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xuyu He
- Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Junior AG, de Almeida TL, Tolouei SEL, Dos Santos AF, Dos Reis Lívero FA. Predictive Value of Sirtuins in Acute Myocardial Infarction - Bridging the Bench to the Clinical Practice. Curr Pharm Des 2021; 27:206-216. [PMID: 33019924 DOI: 10.2174/1381612826666201005153848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 08/09/2020] [Indexed: 11/22/2022]
Abstract
Acute myocardial infarction (AMI) is a non-transmissible condition with high prevalence, morbidity, and mortality. Different strategies for the management of AMI are employed worldwide, but its early diagnosis remains a major challenge. Many molecules have been proposed in recent years as predictive agents in the early detection of AMI, including troponin (C, T, and I), creatine kinase MB isoenzyme, myoglobin, heart-type fatty acid-binding protein, and a family of histone deacetylases with enzymatic activities named sirtuins. Sirtuins may be used as predictive or complementary treatment strategies and the results of recent preclinical studies are promising. However, human clinical trials and data are scarce, and many issues have been raised regarding the predictive values of sirtuins. The present review summarizes research on the predictive value of sirtuins in AMI. We also briefly summarize relevant clinical trials and discuss future perspectives and possible clinical applications.
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Affiliation(s)
- Arquimedes G Junior
- Laboratory of Electrophysiology and Cardiovascular Pharmacology, Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Thiago L de Almeida
- Laboratory of Electrophysiology and Cardiovascular Pharmacology, Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Sara E L Tolouei
- Laboratory of Reproductive Toxicology, Department of Pharmacology, Federal University of Parana, Curitiba, PR, Brazil
| | - Andreia F Dos Santos
- Laboratory of Preclinical Research of Natural Products, Post-Graduate Program in Animal Science with Emphasis on Bioactive Products, Paranaense University, Umuarama, PR, Brazil
| | - Francislaine A Dos Reis Lívero
- Laboratory of Preclinical Research of Natural Products, Post-Graduate Program in Animal Science with Emphasis on Bioactive Products, Paranaense University, Umuarama, PR, Brazil
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Sardu C, Consiglia Trotta M, Santella B, D'Onofrio N, Barbieri M, Rizzo MR, Sasso FC, Scisciola L, Turriziani F, Torella M, Portoghese M, Loreni F, Mureddu S, Lepore MA, Galdiero M, Franci G, Folliero V, Petrillo A, Boatti L, Minicucci F, Mauro C, Calabrò P, Feo MD, Balestrieri ML, Ercolini D, D'Amico M, Paolisso G, Galdiero M, Marfella R. Microbiota thrombus colonization may influence athero-thrombosis in hyperglycemic patients with ST segment elevation myocardialinfarction (STEMI). Marianella study. Diabetes Res Clin Pract 2021; 173:108670. [PMID: 33453294 DOI: 10.1016/j.diabres.2021.108670] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/30/2020] [Accepted: 01/08/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVES We examined the association of the coronary thrombus microbiota and relative metabolites with major adverse cardiovascular events (MACE) in hyperglycemic patients with ST segment elevation myocardial infarction (STEMI). BACKGROUND Hyperglycemia during STEMI may affect both development and progression of coronary thrombus via gut and thrombus microbiota modifications. METHODS We undertook an observational cohort study of 146 first STEMI patients treated with primary percutaneous coronary intervention (PPCI) and thrombus-aspiration (TA). Patients were clustered, based on admission blood glucose levels, in hyperglycemic (≥140 mg/dl) and normoglycemic (<140 mg/dl). We analyzed gut and thrombus microbiota in all patients. Moreover, we assessed TMAO, CD40L and von Willebrand Factor (vWF) in coronary thrombi. Cox regressions were used for the association between Prevotellaspp. and TMAO terziles and MACE. MACE endpoint at 1 year included death, re-infarction, unstable angina. RESULTS In fecal and thrombus samples, we observed a significantly different prevalence of both Prevotellaspp. and Alistipesspp. between patients with hyperglycemia (n = 56) and those with normal glucose levels (n = 90). The abundance of Prevotella increased in hyperglycemic vs normoglycemic patients whereas the contrary was observed for Alistipes. Interestingly, in coronary thrombus, the content of Prevotella was associated with admission blood glucose levels (p < 0.01), thrombus dimensions (p < 0.01), TMAO, CDL40 (p < 0.01) and vWF (p < 0.01) coronary thrombus contents. Multivariate Cox-analysis disclosed a reduced survival in patients with high levels of Prevotella and TMAO in coronary thrombus as compared to patients with low levels of Prevotella and TMAO, after 1-year follow up. CONCLUSIONS Hyperglycemia during STEMI may increase coronary thrombus burden via gut and thrombus microbiota dysbiosis characterized by an increase of Prevotella and TMAO content in thrombi. CLINICAL TRIAL REGISTRATION NCT03439592. September 30, 2016. Ethic Committee Vanvitelli University: 268/2016.
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Affiliation(s)
- Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy.
| | - Maria Consiglia Trotta
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Biagio Santella
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Nunzia D'Onofrio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Italy
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy
| | - Maria Rosaria Rizzo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy
| | - Lucia Scisciola
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy
| | - Fabrizio Turriziani
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy
| | - Michele Torella
- Department of Cardio-Thoracic and Respiratory Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Michele Portoghese
- Department of Cardiac Surgery, Santissima Annunziata Hospital, Sassari, Italy
| | - Francesco Loreni
- Department of Cardio-Thoracic and Respiratory Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Simone Mureddu
- Department of Cardiac Surgery, Santissima Annunziata Hospital, Sassari, Italy
| | - Maria Antonietta Lepore
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy
| | - Massimiliano Galdiero
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Gianluigi Franci
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Veronica Folliero
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Arianna Petrillo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Lara Boatti
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Fabio Minicucci
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Ciro Mauro
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Paolo Calabrò
- Department of Cardio-Thoracic and Respiratory Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Marisa De Feo
- Department of Cardio-Thoracic and Respiratory Sciences, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Danilo Ercolini
- Department of Agricultural Sciences, University of Naples Federico II, Italy; Task Force on Microbiome Studies, University of Naples Federico II, Italy
| | - Michele D'Amico
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy
| | - Marilena Galdiero
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli" Italy, Italy
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Akhtar Z, Aleem MA, Ghosh PK, Islam AKMM, Chowdhury F, MacIntyre CR, Fröbert O. In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh. BMC Cardiovasc Disord 2021; 21:85. [PMID: 33568047 PMCID: PMC7877023 DOI: 10.1186/s12872-021-01896-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/31/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is a paucity of data regarding acute phase (in-hospital and 30-day) major adverse cardiac events (MACE) following ST-segment elevation myocardial infarction (STEMI) in Bangladesh. This study aimed to document MACE during the acute phase post-STEMI to provide information. METHODS We enrolled STEMI patients of the National Institute of Cardiovascular Disease, Dhaka, Bangladesh, from August 2017 to October 2018 and followed up through 30 days post-discharge for MACE, defined as the composite of all-cause death, myocardial infarction, and coronary revascularization. Demographic information, cardiovascular risk factors, and clinical data were registered in a case report form. The Cox proportional hazard model was used for univariate and multivariate analysis to identify potential risk factors for MACE. RESULTS A total of 601 patients, mean age 51.6 ± 10.3 years, 93% male, were enrolled. The mean duration of hospital stay was 3.8 ± 2.4 days. We found 37 patients (6.2%) to experience an in-hospital event, and 45 (7.5%) events occurred within the 30 days post-discharge. In univariate analysis, a significantly increased risk of developing 30-day MACE was observed in patients with more than 12 years of formal education, diabetes mellitus, or a previous diagnosis of heart failure. In a multivariate analysis, the risk of developing 30-day MACE was increased in patients with heart failure (hazard ratio = 4.65; 95% CI 1.64-13.23). CONCLUSIONS A high risk of in-hospital and 30-day MACE in patients with STEMI exists in Bangladesh. Additional resources should be allocated providing guideline-recommended treatment for patients with myocardial infarction in Bangladesh.
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Affiliation(s)
- Zubair Akhtar
- Programme for Emerging Infections, International Center for Diarrhoeal Diseases, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Mohammad Abdul Aleem
- Programme for Emerging Infections, International Center for Diarrhoeal Diseases, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Probir Kumar Ghosh
- Programme for Emerging Infections, International Center for Diarrhoeal Diseases, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - A K M Monwarul Islam
- Department of Cardiology, National Institute of Cardiovascular Diseases Dhaka (NICVD), Dhaka, Bangladesh
| | - Fahmida Chowdhury
- Programme for Emerging Infections, International Center for Diarrhoeal Diseases, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - C Raina MacIntyre
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Ole Fröbert
- Department of Cardiology, Faculty of Health, Örebro University, Örebro, Sweden
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Zhang W, Chang G, Cao L, Ding G. Dysregulation of serum miR-361-5p serves as a biomarker to predict disease onset and short-term prognosis in acute coronary syndrome patients. BMC Cardiovasc Disord 2021; 21:74. [PMID: 33546604 PMCID: PMC7863490 DOI: 10.1186/s12872-021-01891-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/25/2021] [Indexed: 02/08/2023] Open
Abstract
Background Serum microRNAs (miRNAs) have been used as novel biomarkers for various diseases, including acute coronary syndrome (ACS). This study aimed to investigate the expression and clinical significance of microRNA-361-5p (miR-361-5p) in patients with ACS. Methods This study included 118 ACS patients, 78 patients with stable coronary heart disease (SCHD) and 66 healthy controls. MiR-361-5p expression was measured by qRT-PCR. The diagnostic value of miR-361-5p was evaluated by the ROC analysis. A 30-day follow-up was performed for the patients from hospitalization, and Kaplan–Meier curves and logistics analysis were used to evaluate the ability of miR-361-5p to predict the occurrence of major adverse cardiac events (MACE). ELISA kits were used to detect the levels of endothelial dysfunction (ED) markers, including vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1) and E-selectin. Results The expression of miR-361-5p was significantly increased in patients with SCHD and ACS, and positively correlated with Gensini scores. Serum miR-361-5p expression had a high diagnostic accuracy for distinguishing ACS from health controls and SCHD patients. ACS patients with high expression of miR-361-5p had a higher probability of developing MACE. MiR-361-5p expression was an independent risk factor for the occurrence of MACE in ACS patients, and was positively correlated with the levels of VCAM-1, ICAM-1 and E-selectin. Conclusion All data indicated that miR-361-5p expression was significantly increased in ACS patients. Aberrant miR-361-5p expression in ACS might be a candidate biomarker for ACS diagnosis and the the prediction of MACE onset.
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Affiliation(s)
- Wenqing Zhang
- Department of Geriatrics, Yidu Central Hospital of Weifang, WeifangShandong, 262500, China
| | - Guannan Chang
- Department of Cardiology, Yidu Central Hospital of Weifang, No. 4138, Linglongshan South Road, Qingzhou, Weifang, 262500, Shandong, China.
| | - Liya Cao
- Department of Gynecology Ward II, Yidu Central Hospital of Weifang, Weifang, 262500, Shandong, China
| | - Gang Ding
- Department of Science and Education, Yidu Central Hospital of Weifang, Weifang, 262500, Shandong, China
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Song T, Fu Y, Wang Y, Li W, Zhao J, Wang X, Wang H, Zhao Y, Fu X. FGF-23 correlates with endocrine and metabolism dysregulation, worse cardiac and renal function, inflammation level, stenosis degree, and independently predicts in-stent restenosis risk in coronary heart disease patients underwent drug-eluting-stent PCI. BMC Cardiovasc Disord 2021; 21:24. [PMID: 33413149 PMCID: PMC7791850 DOI: 10.1186/s12872-020-01839-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/25/2020] [Indexed: 12/18/2022] Open
Abstract
Background The present study aimed to assess the correlation of fibroblast growth factor (FGF)-23 expression with clinical characteristics, then further explore its value in predicting 2-year in-stent restenosis (ISR) risk in coronary heart disease (CHD) patients underwent percutaneous coronary intervention (PCI) with drug-eluting stent (DES). Methods In this prospective, single-center, observational study, totally 214 CHD patients treated by PCI with DES were consecutively recruited, and peripheral blood samples were collected prior to PCI with DES for serum samples isolation. Following, FGF-23 level in the serum samples was detected via enzyme linked-immuno-sorbent Assay. The follow-up coronary angiography was performed at 1 year and 2 years after PCI or if suspected ISR symptoms occurred. Results FGF-23 was positively correlated with fasting blood-glucose, insulin resistance, serum creatinine, serum uric acid, LDL-C, high-sensitivity C-reactive protein, cardiac troponin I and N-terminal-proB-type natriuretic peptide, while was negatively associated with HDL-C and left ventricular ejection fraction (all P < 0.01). Furthermore, FGF-23 was positively correlated with hypercholesteremia, hyperuricemia and family history of CAD (all P < 0.05). However, it did not correlate with other chronic complications, biochemical indexes, lesion features or PCI parameters (all P > 0.05). Moreover, FGF-23 level was higher in 2-year ISR patients (n = 38) compared to 2-year non-ISR patients (n = 176) (P < 0.001), and receiver operating characteristic curve indicated that FGF-23 was of good value in predicting 2-year ISR risk (AUC 0.828, 95% CI 0.761–0.896). Conclusion FGF-23 correlates with endocrine and metabolism dysregulation, worse cardiac and renal function, inflammation level, stenosis degree of target lesion, and serves as an independent risk factor for 2-year ISR risk in CHD patients underwent PCI with DES.
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Affiliation(s)
- Tingting Song
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Yang Fu
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Yanbo Wang
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Wei Li
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Jiayu Zhao
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Xun Wang
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Haiyan Wang
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Ying Zhao
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China
| | - Xianghua Fu
- Department of Cardiology, The Second Hospital of Hebei Medical University, 215 West Heping Road, Shijiazhuang, 050000, China.
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Sardu C, Paolisso G, Marfella R. Inflammatory Related Cardiovascular Diseases: From Molecular Mechanisms to Therapeutic Targets. Curr Pharm Des 2020; 26:2565-2573. [PMID: 32053065 DOI: 10.2174/1381612826666200213123029] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023]
Abstract
Inflammation is a pathogenic response to multiple factors, that causes over-activation of different molecules and pro-inflammatory cellular lines. Different behavioral factors and risk factors might enhance the inflammatory stress, and this might cause cardiovascular disease (CVD). CVD is the world's leading cause of morbidity and mortality, and it is represented by hypertension, coronary heart disease, cerebrovascular disease, peripheral vascular disease, heart failure, rheumatic heart disease, congenital heart disease and cardiomyopathies. In this context, inflammation is both a cause and an aggravating factor in CVD, as well as a mediator of its worst prognostic. The mechanisms that link inflammation to CVD are multiple, complex and multi-factorial. To date, the role of inflammation in the genesis and progression of CVD has been extensively analyzed in recent studies. However, in the last decades, new biomarkers are joining the already known inflammatory biomarkers, such as Creactive protein, interleukins, tumor necrosis factor alpha and nitrotyrosine. Among these new biomarkers, we have to report sirtuins, microRNAs, ST2 protein, apolipoprotein E protein, adiponectin, and others. These biomarkers are preferentially expressed locally in the target tissue of inflammation, but also released in peripheral blood and then used as diagnostic and prognostic biomarkers. Indeed, these biomarkers might also predict future adverse cardiovascular events and worse prognosis in patients with CVD. Furthermore, these new inflammatory biomarkers can also be analyzed to evaluate therapeutic efficacy in patients with CVD. Furthermore, this might open up new fields and interesting research concerning the link between inflammation and CVD.
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Affiliation(s)
- Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy,Department of Medical Sciences, International University of Health and Medical Sciences “Saint Camillus”, Rome, Italy
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Gao N, Qi X, Dang Y, Li Y, Wang G, Liu X, Zhu N, Fu J. Establishment and validation of a risk model for prediction of in-hospital mortality in patients with acute ST-elevation myocardial infarction after primary PCI. BMC Cardiovasc Disord 2020; 20:513. [PMID: 33297955 PMCID: PMC7727168 DOI: 10.1186/s12872-020-01804-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 11/30/2020] [Indexed: 12/18/2022] Open
Abstract
Background Currently, how to accurately determine the patient prognosis after a percutaneous coronary intervention (PCI) remains unclear and may vary among populations, hospitals, and datasets. The aim of this study was to establish a prediction model of in-hospital mortality risk after primary PCI in patients with acute ST-elevated myocardial infarction (STEMI). Methods This was a multicenter, observational study of patients with acute STEMI who underwent primary PCI. The outcome was in-hospital mortality. The least absolute shrinkage and selection operator (LASSO) method was used to select the features that were the most significantly associated with the outcome. A regression model was built using the selected variables to select the significant predictors of mortality. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate the performance of the nomogram. Results Totally, 1169 and 316 patients were enrolled in the training and validation sets, respectively. Fourteen predictors were identified by the LASSO analysis: sex, Killip classification, left main coronary artery disease (LMCAD), grading of thrombus, TIMI classification, slow flow, application of IABP, administration of β-blocker, ACEI/ARB, symptom-to-door time (SDT), symptom-to-balloon time (SBT), syntax score, left ventricular ejection fraction (LVEF), and CK-MB peak. The mortality risk prediction nomogram achieved good discrimination for in-hospital mortality (training set: C-statistic = 0.987; model calibration: P = 0.722; validation set: C-statistic = 0.984, model calibration: P = 0.669). Area under the curve (AUC) values for the training and validation sets are 0.987 (95% CI: 0.981–0.994, P = 0.003) and 0.990 (95% CI: 0.987–0.998, P = 0.007), respectively. DCA shows that the nomogram can achieve good net benefit. Conclusions A novel nomogram was developed and is a simple and accurate tool for predicting the risk of in-hospital mortality in patients with acute STEMI who underwent primary PCI.
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Affiliation(s)
- Nan Gao
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xiaoyong Qi
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China.
| | - Yi Dang
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Yingxiao Li
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Gang Wang
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Xiao Liu
- Department of Cardiology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Ning Zhu
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jinguo Fu
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou, Hebei, China
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50
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Ma X, Sun Y, Cheng Y, Shen H, Gao F, Qi J, Yang L, Wang Z, Shi D, Liu Y, Liu X, Zhou Y. Prognostic impact of the atherogenic index of plasma in type 2 diabetes mellitus patients with acute coronary syndrome undergoing percutaneous coronary intervention. Lipids Health Dis 2020; 19:240. [PMID: 33198752 PMCID: PMC7667811 DOI: 10.1186/s12944-020-01418-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/09/2020] [Indexed: 12/21/2022] Open
Abstract
Background The association of the atherogenic index of plasma (AIP), an emerging lipid index that can predict the risk for cardiovascular disease, with adverse outcomes in type 2 diabetes mellitus (T2DM) patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) has not been determined. Therefore, the aim of this study was to investigate whether the AIP could independently predict adverse cardiovascular events in T2DM patients with ACS undergoing PCI. Methods This study was a retrospective analysis of a single-centre prospective registry involving 826 consecutive T2DM patients who underwent primary or elective PCI for ACS from June 2016 to November 2017. This study ultimately included 798 patients (age, 61 ± 10 years; male, 72.7%). The AIP was calculated as the base 10 logarithm of the ratio of the plasma concentration of triglycerides to high-density lipoprotein-cholesterol (HDL-C). All the patients were divided into 4 groups based on the AIP quartiles. The primary endpoint was a composite of death from any cause, non-fatal spontaneous myocardial infarction (MI), non-fatal ischaemic stroke, and unplanned repeat revascularization. The key secondary endpoint was a composite of cardiovascular death, non-fatal MI, and non-fatal ischaemic stroke. Results During a median follow-up period of 927 days, 198 patients developed at least one event. An unadjusted Kaplan-Meier analysis showed that the incidence of the primary endpoint increased gradually with rising AIP quartiles (log-rank test, P = 0.001). A multivariate Cox proportional hazards analysis revealed that compared with the lowest AIP quartile, the top AIP quartile was associated with significantly increased risk for the primary and key secondary endpoints (hazard ratio [HR]: 2.249, 95% confidence interval [CI]: 1.438 to 3.517, P < 0.001; and HR: 2.571, 95% CI: 1.027 to 6.440, P = 0.044, respectively). Conclusions A higher AIP value on admission was independently and strongly associated with adverse cardiovascular events in T2DM patients with ACS undergoing PCI.
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Affiliation(s)
- Xiaoteng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Yan Sun
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Yujing Cheng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Hua Shen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Fei Gao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Jing Qi
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Lixia Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Zhijian Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Dongmei Shi
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Yuyang Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Xiaoli Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China.
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China.
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